The recent pandemic has shown that having a good health insurance plan is the need of the hour. Health insurance plans act as a safety net against any kind of medical emergency. It protects individuals from draining their life savings which would otherwise be lost on account of the steep medical costs. The rising inflation cost is another factor that has increased medical costs among many other things. The impact of such increased costs has resulted in any existing health insurance plans being inadequate. The solution to such situations is to either take a new plan or an addition to the existing plan. A Super top-up plan is an addition to the existing health insurance plan.
Given below is the meaning of a Super top-up plan and related details for the same.
What is a super top-up health insurance plan?
A Super top-up health insurance plan is a type of an addition to an existing health insurance plan when the current cover may not be sufficient to meet the medical expenses. This plan helps in covering the total hospital bills up to a specified limit under the super to-up plan and over the deductible amount.
The basic difference between a simple top-up plan and a super top-up plan is that the latter is used for claims relating to the annual medical expenses of the insured person and their family rather than on a per claim basis. The super top-up plan is activated once the threshold of the original health insurance plan is exhausted.
The advantage of super top-up plans is that it considers the aggregate of the total hospitalization bills in a year to calculate the amount payable over and above the deductible. Hence, if a person is prone to hospitalization or needs cover for chronic ailments or diseases, they can opt for a super top-up health plan. This will increase the coverage for the insured persons at a nominal premium rather than taking a new health insurance policy.
What are the features of a Super Top-up health insurance plan?
The key features of Super Top-up health insurance plans are discussed hereunder.
- Coverage against Covid
In the wake of the recent pandemic, the Super top-up plans are equipped to provide coverage against the covid diagnosis. All the treatment and hospitalization costs on account of covid are included in the super top-up plans.
- One time payment of the deductible
The plan requires the insured party to pay the deductible only once. Following this, they can claim all the hospitalization costs multiple times during the policy term. This is a huge advantage over the basic top-up plans.
- Availability of higher sum insured
Through Super top-up plans, individuals can secure higher coverage for themselves and their family members. This plan can be used to boost the basic health insurance coverage provided by corporate plans or health insurance plans with standard coverage at a nominal premium. Such benefit is especially welcome in the case of senior citizens where the premiums to be paid for their health insurance coverage are quite higher.
- Increased tax saving option
A Super top-up plan works similar to any other health insurance plan in terms of tax benefits. Individuals can claim the additional tax benefits under section 80D as per the prescribed guidelines and reduce their tax burden.
- Hassle-free claim settlement
The claim settlement process for super top-up plans is also quite hassle-free. Customers can either avail opt for cashless treatment from the notified network of hospitals or get reimbursement of their expenses by simply providing the necessary documents to process their claims.
- Customizable plan
Individuals can customize their super top-up health insurance plans by choosing the amount of deductible as per their current health insurance plan. Therefore, they can lower their premium by selecting a higher deductible and also get higher coverage for themselves and their family members.
What is the need for a super top-up health insurance plan?
There can be many reasons why a person would need a super top-up health insurance plan. Some of the common reasons prompting such need are highlighted below.
- Increase in health insurance coverage provided by employers
Even today, many do not understand the importance of having health insurance. The health insurance coverage provided by the employers is therefore considered sufficient for them. However, such cover is often inadequate, and therefore, employees need to take a super top-up plan for excess health insurance cover.
- Increase an insufficient health coverage
The medical costs in the country are on a constant rise. This often makes the existing health coverage insufficient. Therefore, it gives rise to the need for additional coverage which can be easily available through a super top-up plan at a nominal excess premium.
- Excess coverage for senior citizens
Health insurance for senior citizens is especially costly. With the super top-up plans, senior citizens get higher coverage at considerably lower additional costs. The only hindrance, in this case, will be the payment of the deductible from the existing health insurance plan or corporate plan.
What are the inclusions and exclusions in the super top-up health insurance plans?
Like any other health insurance policy, a super top-up plan also has its own set of inclusions and exclusions. These are mentioned hereunder.
The common inclusions in most super top-up health insurance plans are
- Coverage for pre and post-hospitalization costs
- Any daycare procedures that may not require hospitalization of more than 24 hours are covered under the super top-up plans
- The annual health check-up which is also termed a preventive health check-up can be claimed under the super top-up plans after the completion of a specific time period.
- The charges for the room rent for ICU rooms are included in the super top-up plan
- Ambulance charges although basic are expressly included in the super top-up plan.
The most common exclusions in any super top-up health insurance plan are mentioned below.
- Claims under the super top-up plan cannot be raised until the policy deductible limit is crossed
- The plan does not include the medical costs for newborn or dental surgery unless they require hospitalization
- Other medical procedures not included are elective plastic surgeries, any loss or injuries due to any war, invasion, acts of foreign enemies, hostilities, HIV or AIDs treatment, cost of spectacles, contact lenses and hearing aids, and experimental treatments, etc.
- These plans also do not vaccinations or inoculations unless they are implemented for any animal bites or as part of any treatment procedure.
- Also, the use of vitamins or supplements is not covered under the plan unless it is discharged as part of in-patient hospitalization.
Super top-up health insurance plans are an easier way to increase health insurance coverage and get access to better medical facilities. This helps in giving the patients a better fighting chance against their ailments and diseases at nominal increased premium costs rather than taking a new health insurance policy for their increased medical needs.
There are two types of claims that can be filed under super top-up health insurance plans i.e.,
-Through a cashless treatment where the insured party can take treatment in the specified network of hospitals without paying any cash upfront, or,
-Through reimbursement of the medical costs by informing the insurer at the time of admission to the hospital and providing all the relevant documents and hospital bills for settlement of claims
Yes. The revised directive of the IRDAI has made all the super top-up plans to cover for the covid treatment.
Yes, super top-up plans allow the insured party to opt for a higher deductible as per their convenience.
Some of the major considerations while opting for super top-up plans are
-Affordability of the higher coverage by the insured party
-List of hospitals in the network of the insurer