Considering the rising medical inflation and increasing hospital bills, a basic health insurance plan is likely to be exhausted during major illnesses or multiple hospitalisations. Here comes the need for top-up health insurance that offers additional financial coverage to meet your health expenses. So, families or individuals looking for a comprehensive safety net for their healthcare needs without paying a higher premium can opt for a top-up plan.
Keep scrolling to learn how to pick the best top-up health insurance plan based on your needs!
Features to Look for in Top-up Health Insurance Plans
Here are some of the key features you should look for when purchasing top-up health insurance plans:
- Deductible-Based Coverage
When your treatment costs exceed the pre-defined deductible amount, top-up plans help cover the additional expenses. Thus, when buying top-up health insurance policies, check the amount of money you have to spend before the top-up coverage kicks in.
If that amount is covered by the sum insured of your base plan, you just need to pay the latter’s deductible to get coverage from both your medical insurance policy and the top-up policy. This is a smart way to save out-of-pocket costs during medical emergencies.
- Additional Sum Insured
Check the additional sum insured amount offered by various top-up plans and their associated premiums. Then, assess your healthcare needs and choose an amount accordingly. By doing so, you can get coverage for expensive treatments and hospitalisations that go above your base policy limits, reducing the chances of major out-of-pocket expenses.
- Coverage for Pre- and Post-Hospitalisation Expenses
Not all health insurance plans cover the expenses incurred before and after hospitalisation. So, while buying top-up plans, check whether they cover these costs. Consider going for a top-up policy that provides coverage of up to 60 days before, and 90 days after hospitalisation.
- Coverage for Daycare and Domiciliary Treatments
Check whether the top-up plan offers coverage for daycare procedures like chemotherapy or dialysis. Additionally, check the coverage for domiciliary treatment. Coverage for such aspects comes in really handy when you or a loved one is dealing with a long-term chronic condition.
- Lifetime Renewability
When buying a top-up plan, check whether it offers lifetime renewability. This ensures that even as the policyholder ages, the top-up policy keeps on providing additional coverage, enabling them to easily meet rising healthcare costs.
- Super Top-Up Option
Some health insurance plans provide “super top-up” features to cover cumulative insurance claims that go beyond the deductible. This is ideal for individuals who make multiple smaller claims.
How is a Top-up Health Plan Different from Health Insurance Policies?
Before buying a top-up health insurance plan, policyholders must understand its differences from the base plan:
| Aspect | Top-up Health Plans | Basic Health Insurance Policies |
| Sum Insured | It supplements the base policy by providing additional health insurance coverage beyond the deductible limit. | Offers a fixed sum insured to cover hospitalisation expenses directly. |
| Purpose | It is designed to extend health insurance coverage once the coverage limit of the base policy is exhausted. | It acts as a primary health insurance plan that covers a wide range of healthcare expenses. |
| Claim Process | Claims for top-up plans can only be processed if the total medical bills exceed the deductible; expenses under the deductible are not covered. | Claims for basic health insurance policies are processed for all eligible medical expenses within the sum insured. |
| Suitable for | It is ideal for policyholders who already have the base plan and are looking to increase the overall insurance protection without excessive premium burden. | It is suitable for an individual policyholder or families who need medical coverage from day one of any medical situation. |
| Flexibility | Offers flexible sum insured and deductible options to provide the much-needed financial cushion. | Offers fixed sum insured and coverage benefits as per the health insurance policy terms. |
Different Types of Deductibles in a Top-up Health Insurance Plan
Deductibles are the fixed amounts that you need to pay out-of-pocket before the insurance company starts covering medical expenses. In top-up health insurance, you are allowed to cover the deductible with your base health plan and then avail the benefits of additional coverage.
Here are some of the deductibles that are relevant to top-up health insurance plans:
- Cumulative Deductible
A cumulative deductible is applied against the total medical bills in a policy year. It accumulates medical expenses for all the members insured under a family floater policy. Once the total claims exceed the deductible, the top-up plan covers the remaining medical costs.
This feature is particularly beneficial for families who make multiple medical claims, as expenses across members contribute to meeting the deductible.
- Voluntary Deductible
The policyholder can choose this deductible voluntarily at the time of purchasing the top-up health plan. Opting for a higher voluntary deductible helps lower the policy premium because the insured agrees to bear a greater share of initial expenses. This option suits those who make fewer claims and want to save on premium costs while maintaining high coverage for major expenses.
- Compulsory Deductible
This is a mandatory deductible fixed by the insurer, which the insured must pay for every claim raised. It is usually non-negotiable and may be a fixed amount or a percentage of the sum insured. The premium typically does not decrease with the compulsory deductible since it is set by the insurer as part of the policy terms. It ensures the policyholder shares some cost in all claims.
Top-up and super top-up health insurance plans provide the necessary financial coverage for health-related expenses of families and individuals. It provides enhanced protection at affordable premiums, customisable options, and helps avoid financial distress due to high medical bills.
Thus, if the coverage of your current health insurance plan is not enough, opting for a top-up or super top-up health plan can be a cost-effective solution. However, do check the insurer’s reputation, claim settlement ratio, inclusions, exclusions, and other details to avoid surprises during claims.
