Why policyholders should know about super top-up Option

A super top-up health insurance policy could be a cost-effective strategy to protect yourself from repeated treatments while also beating medical inflation.

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How a super top-up health insurance plan can help you

Medical inflation is an unfortunate reality of the health care industry right now. The cost of quality health care is rising rapidly with each passing year. Recent world events ushered in by the coronavirus pandemic have ensured that this rise in prices will continue for the near future. In such a situation, having a comprehensive health insurance plan is extremely important as they provide considerable protection against significant financial burden that could be caused by rising medical expenses.

But often, the sum insured offered by your health insurance plan is nowhere near enough to meet the medical needs of you and your family. This gap between your needs and the means can be filled using a super top-up plan. These kinds of health insurance plans are a cost-effective way to get financial coverage for medical emergencies that you might have to face.

What is Super Top-Up Health Insurance?

The concept of a super top-up health insurance plan is much more straightforward than it sounds. Essentially, a super top-up plan will provide financial coverage for the entire hospital bill after it has reached a minimum amount- this minimum amount is called the deductible. Once you pay the deductible amount, you can claim the rest of the bill amount through the super top-up policy.

Here is the first advantage of a super top-up plan in comparison to a regular top-up plan. If you have a super top-up health insurance plan, you can make multiple cumulative claims. While in a standard top-up plan, you can only make a single claim after the deductible amount is reached. This is a very significant advantage to have when you or your family members must endure long-term treatment for your ailments.

The deductible amount is pre-determined, and you can use your existing health care insurance plan to pay for it. How does this work? Well, the answer is simple. For example, if you have a super-top plan of ₹8 lakhs with a deductible amount of ₹1.5 lakh. So, if you have a hospital bill of ₹5 lakhs, you and your existing health insurance will pay for the deductible amount. Once the ₹1.5 lakh is paid, the super top-up insurer will pay the rest of the bill up to the insured sum.

Some Key Benefits of Super Top-up Health Care Insurance Plans

These are benefits you need to keep in mind when you are considering the merit of a super top-up plan for you and your family: -

  • The deductible needs to be paid only once! Yes, you read that correctly. This is a one-time payment. The insurer will pay for any other accumulated medical expenses.
  • The super-top plans also provide you with the facility of cashless treatment. This is particularly handy when you consider the large sums of money that medical bills may demand.
  • Many super top-ups plans also offer the option of purchase through online platforms. This makes renewal and purchase of these plans super simple, especially in medical emergencies - when these services are most needed.
  • Since this is a provision designed to be used during emergencies, COVID-19 treatment is also covered. This is a substantial advantage for many people during the current times.

Why Should You Purchase a Super Top-up Health Plan?

There are many reasons why a super top-up health plan can be advantageous for you and your family. Here is a list of possible scenarios in which a super top-up plan can be life-saving: -

  • Often people have health insurance coverage through their employer. This can give you access to a standard health care insurance plan. The sum insured and the financial and medical coverage provided by these plans are generally not very expansive. Super top-up plans are a practical choice for upgrading your employer's health plan when you are in need.
  • As one's age increases, the cost of premiums and the need for quality health care also increase. Super top-up plans are the cheaper option for many senior citizens. The only real drawback to this strategy is that you still pay the deductible amount - which is not insignificant.
  • Overall, no matter your situation, do you need an immediate increase in your coverage because your current health plan is insufficient? Super top-up plans are the answer to your problems. In emergencies procuring a comprehensive health plan is not an option. Those take time to get approval for and are often not effective immediately. A super top-up plan will help you cover the medical expenses you accrue in the meantime.

A Comprehensive List of the Features and Benefits of a Super Top-up Health Care Insurance Plan

There are several benefits and features of a super top-up plan that you should familiarize yourself with before purchasing one of these plans. Here is an itemized list to make it easier for you to peruse: -

  • COVID-19 treatment is covered. Many health insurance plans will not provide coverage for treatment for COVID-19 unless you have specific policies or add-ons. Super top-up plans cover COVID-19 along with other illnesses.
  • Customizable limit for deductibles. Keeping in mind your existing health care insurance plan and the insured sum, you can choose which deductible is within your budget. This feature helps you make the best choice for yourself.
  • Pay the deductible once, and only once! A super top-up policy means you pay your deductible once. And when this payment is made, you can make multiple claims on the super top-up policy during the policy's term.
  • Increasing the insured sum. The super top-up policy allows you to enjoy the benefits of a higher sum insured. This allows you more financial security and ensures that you have access to quality health care services when you need them.
  • Better coverage for senior citizens. Often the premiums for senior citizens are high, and the health care plans are limited in what they cover - both medically and financially. A super top-up plan offers you a much more flexible way of paying for the medical expenses accrued at a lower premium.
  • Tax Benefits! Like many other health care insurance plans, super top-up plans are also covered by Section 80D of the Income Tax Act. There are tax benefits that you can redeem. The number of benefits is based on the premium you pay for the super top-up plan.
  • Access to super top-up plans is quick and without any hassle. As these plans are often needed in emergencies, these policies can be purchased online without any hassles.
  • Treatment at hospitals that are a part of the insurance company's network. Having a super top-up policy gives you access to the insurance company's hospital network. This has the benefit of availing of cashless transactions and reimbursements where it is needed.

The Differences Between Top-up Health Care Plans and Super Top-up Health Care Plans

The difference between the two is simple and boils down to financial coverage. A top-up plan will provide additional coverage by increasing the sum insured, just like a super top-up plan.

However, the key difference is that the top-up plans allow for only a single claim to be made in a policy period after the deductible has reached the threshold limit where super top-up plans allow for multiple claims to be made during the policy period once the threshold limit has been reached and the deductible has been paid.

This fact also means that if your deductible is not paid as one single amount. Then the standard top-up plan will not be activated. However, this is not true of the super top-up health care plans. As long as the deductible is paid, even throughout multiple claims, the super top-up policy will pay for the rest.

The Medical Services Covered by Super Top-up Health Care Plans

A super top-up health care plan will cover all hospitalization expenses. This includes the costs of doctor fees, surgeon consult, specialists, anaesthetists, nurse fees, diagnostic testing, surgical tools, anaesthesia, blood bags, oxygen tanks, medical supplies, operating theatre charges, etcetera. Even the cost of prosthetics and implants are covered if they are needed as part of a surgical process.

Of course, each plan offered by each insurance company is different. So, do be careful and read up on each offering before deciding.

Other relevant expenses that are commonly covered by super top-up health insurance include:

  • Day Care or Out-Patient Procedures - This includes the treatments which require you to be in the hospital for less than 24 hours. For example, radiotherapy, chemotherapy, dialysis, etc.
  • Pre- and Post- Hospitalization Expenses - All costs of treatment at a hospital are covered. This includes the treatment leading up to and after a hospital stay.
  • Intensive Care Unit (ICU) Expenses - This includes room rent, nursing fees, and the cost of specialized machinery that you may need. Often, there are generous allowances made for room rent in super top-up health care policies.
  • Road Ambulance Expenses - Often not covered by health insurance plans unless you pick it specifically. This is a very basic and necessary facility that is particularly useful in emergencies.
  • A Complimentary Annual Health Checkup - This is a bonus perk offered by super top-up plans after you complete a set amount of time under the policy.

Medical Services Not Covered by Super Top-up Health Care Plans

While there are several advantages of a super top-up health care insurance policy, there are several limitations to it, as well. To help you make an informed decision, you must familiarize yourself with both ends of the spectrum.

Here is a list of all the medical services not covered by a super top-up health insurance policy: -

  • You can make no claims until your deductible has been paid off. This can take some time to happen, especially if your medical costs are not very high.
  • Newborn babies and any expenses related to their care are not covered by the super top-up health care policies.
  • Organ donation - whether before or after hospitalization - and any expenses related to this procedure are not covered by the super top-up health care policies.
  • Routine dental surgeries are not covered. Unless the dental surgery also requires hospitalization.
  • Like most health care plans, super top-up health care policies do not cover the cost of treatment of surgeries caused by:
  1. Rebellions
  2. War
  3. Civil unrest,
  4. Invasion by foreign entities
  5. Any other violent terror attack
  • Plastic surgeries which are medically unnecessary are not covered, as well.
  • Visual (contact lenses or spectacles) or audio (hearing aids) aids are not covered unless the visual or audio aid is utilized in a surgical procedure.
  • Stem cell implantation surgeries are not covered.
  • This plan does not cover the treatment of congenital diseases.
  • Treatment of problems caused by drug or alcohol abuse is not covered.
  • This policy does not cover the treatment of venereal diseases.
  • HIV or AIDS treatment is not covered by this policy, like most other health care insurance plans.
  • This plan does not cover vaccinations or inoculations against diseases unless the vaccination is a part of another treatment or is needed because of an animal bite.
  • This policy does not cover the costs of vitamin and mineral supplements unless the supplements in question are required as part of an in-patient hospital treatment plan.
  • All experimental treatments are not given coverage.

How to File a Claim - Super Top-up Health Care Plan Edition

There are two ways you can go about filing a claim for Super top-up health care insurance plans. The process is very similar to the general healthcare plan claim process. Here is a short guide to help you find your feet in this matter:

  1. Filing for a reimbursement claim - This is when you have been treated and paid out of pocket. Filing this claim gets you a reimbursement of the appropriate amount. The way you do this is by informing the insurance company as soon as you have been hospitalized. The claim can be registered online through the insurance company's website or by email. You must ensure to provide the insurance company with all bills and documents regarding your hospital stay within a specified period after being discharged. The insurance company will then verify your claim and reimburse you appropriately.
  2. Filing for a cashless claim - This process is quite simple. All you need to do is get admitted into one of the hospitals which is a part of the insurance company's network. Here you can just register at the TPA help desk and provide them with the necessary details. If all is in order? Your claim will be approved quickly, and the bills will be taken care of. If at all required, you might be asked to pay a certain amount if the TPA does not approve the usage of some equipment or treatment.

The benefits offered by a super top-up health care plan are quite extensive and would certainly make for a wise decision if you choose such a plan for your healthcare coverage.

Frequently Asked Questions

Q. How does super top-up health insurance work?

A. The super top-up health insurance policies work on the basis that you pay the pre-determined deductible. Once the deductible is paid by you and your existing health insurance policy, the rest of the insured sum is taken care of by the super top-up policy. The deductible can be paid over cumulative expenses, and you can make multiple claims in the policy period.

Q. What is a super top-up health insurance plan?

A. It is an additional plan that you can buy to extend the sum insured by your general health care policy. This allows you to have added medical and financial safety in the case of emergencies.

Q. Is a super top-up health care policy cashless?

A. A super top-up policy is cashless if the treatment you seek is at a hospital part of the insurance company's network. This makes treatment super easy and hassle-free!


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