Super Top-up Health Insurance

Check the features, benefits and know how to raise a claim for super-top up health insurance.
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Super Top-up Health Insurance
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3 mins
20 July 2023

Super top-up health insurance is an excellent add-on to a standard health insurance plan that provides additional coverage without increasing the premium drastically. The policy covers all medical expenses like any other health insurance policy.

What is super top-up health insurance?

Super top-up health insurance is a type of health insurance plan that enhances your regular health insurance plan by giving extra financial protection. It provides extra coverage, like a regular top-up policy, but with a higher threshold limit. A super top-up covers all hospitalisations beyond the threshold limit for the policy year.

Key features of super top-up health insurance

Here’s a quick look at the key features of the super top-up health insurance plan.

Features

Description

Sum insured

Up to Rs. 50 lakh

Room rent

Covered up to the sum insured by the policy.

Pre-hospitalisation expenses

Covered up to 60 days, depending on the policy chosen.

Post-hospitalisation expenses

Covered up to 90 days, depending on the policy chosen.

ICU charges

Covered up to sum insured on the policy.

Cashless services

Available at networks hospitals

How does super top-up health insurance work?

Super top-up health insurance works in a simple way. A super top-up plan covers the expenses over and above a regular health insurance policy. For instance, you have a regular health insurance policy with a coverage limit of Rs. 5 lakh. If you incur medical expenses of Rs. 7 lakh in a year, the regular health insurance policy will pay for Rs. 5 lakh. The super top-up policy will cover the additional Rs. 2 lakh. The coverage depends on the policy terms and conditions.

Difference between super top-up health insurance and top-up health insurance

Here’s a quick look at the common difference between super top-up health insurance and top-up health insurance.

Parameters

Super top-up health insurance

Top-up health insurance

Definition

An add-on policy that provides extra coverage with a higher threshold limit.

An add-on policy that provides additional coverage over and above the base health insurance policy for a single incident.

Policy trigger

Triggered at a predetermined threshold limit for a year.

Triggered at a predetermined deductible limit for a single incident.

Claim

Covers all hospitalisations beyond the threshold limit for a year.

Covers a single hospitalisation beyond the deductible limit.

Premium

Relatively higher

Relatively lower

Suitability

Ideal for individuals with chronic medical conditions with recurring healthcare expenses.

Ideal for individuals who want to protect themselves financially from unexpected hospitalisations without paying a hefty premium.

Advantages of super top-up health insurance

Know the benefits of having the best super top-up health insurance plan.

High coverage: Super top-up health insurance provides coverage beyond the limit of the base health insurance policy.

Cost-effective: Super top-up health insurance comes at an affordable premium, offering additional coverage.

Customisation: You can customise the policy as per your medical needs.

Pay a single deductible: You need to pay the deductible amount only once. After which, you can claim benefits multiple times in a year.

Key inclusions of super top-up health insurance

Here are some of the key inclusions of super top-up health insurance.

Pre-and post-hospitalisation expenses:

Super top-up health insurance covers all medical expenses incurred before and after hospitalisation. This includes the cost of doctor consultations, medical tests, and medications. You get coverage for up to 60 days before and 90 days after hospitalisation. The duration may depend on the policy chosen and the insurer’s terms and conditions.

In-patient hospitalisation expenses:

The policy covers the cost of hospital room rent, surgical expenses, and ICU charges, among others.

Daycare medical procedures:

Super top-up health insurance policy covers minor surgeries that require hospitalisation for less than 24 hours. Examples include cataract surgeries, dental surgeries, chemotherapy, and tonsillectomies.

Ambulance charges:

Super top-up health insurance covers ambulance charges that include transportation to the hospital during an emergency. This is particularly important in case of life-threatening emergencies where time is of the essence. The policy covers both air and road ambulance charges.

Key exclusions of super top-up health insurance

Here are some key exclusions under super top-up health insurance.

  • Does not cover medical expenses related to pre-existing conditions for a particular period.
  • Does not cover treatment of an illness or injury caused by alcohol or drug abuse.
  • Does not cover cosmetic surgery or any other non-medical treatment.

Why should I buy a super top-up health insurance plan?

Here are some reasons why buying a super top-up health insurance plan makes sense:

Affordable: Super top-up health insurance plans have lower premiums compared to traditional health insurance policies.

Additional coverage: Super top-up health insurance plans provide additional coverage when the sum insured in your primary health insurance policy is exhausted.

Comprehensive coverage: Super top-up health insurance plans provide comprehensive coverage for hospitalisation expenses, treatments, and other medical expenses.

Customisable: Super top-up health insurance plans are flexible and allow policyholders to customise them as per their needs and budget.

How to file a claim for super top-up health plan?

You can file claims in two ways, either cashless or reimbursement claim settlement. For both types of claim settlements, you need to inform the insurance company about the hospitalisation or medical treatment in time. In case of emergency, inform within 48 hours, and if planned, then three days before the admission.

Cashless claim settlement

  • Choose a network hospital and inform the insurer.
  • The insurer will then provide you with a pre-authorisation letter that you need to submit at the network hospital. The insurance admin at the hospital can also get the pre-authorisation done.
  • Following this, the network hospital will submit the required documents and the claim form.
  • Upon reviewing the claim request, the insurer will approve and directly settle the bills with the hospital.

Reimbursement claim settlement

  • If you visit any other hospital not empanelled with the insurer, you can raise a reimbursement claim.
  • Download the claim form online and fill in the details.
  • Provide necessary documents such as hospital discharge summary, medical bills, and investigation reports within 15 days of discharge. Also, provide health insurance policy copy, and duly filled claim form for reimbursement claim settlement.
  • The insurance provider will review all the documents and notify you regarding the approval within a few days. If approved, the insurer will reimburse the amount as per the policy terms and conditions.
  • You will receive the amount in your registered bank account.

You can buy a super top-up health insurance policy with a comprehensive health insurance policy. Super top-up health insurance policy offers comprehensive coverage, ensuring you do not face any financial constraints while availing medical treatment. It helps you focus on your recovery without worrying about the funds.

Frequently asked questions

What is the difference between a regular health insurance plan and super top-up health insurance?

A regular health insurance plan covers medical expenses up to a certain limit. A super top-up health insurance policy provides additional coverage when your regular health insurance policy limit gets exhausted. 

How does a super top-up health insurance benefit my parents?

As parents age, medical expenses tend to increase, and a super top-up health insurance policy can provide much-needed financial assistance. You can get a super top-up health insurance plan along with the parents health insurance plan. With a super top-up health insurance policy, your parents can avail of additional coverage at a relatively low cost. It ensures access to quality medical care without having to worry about the cost implications.

What are the major factors that affect the premium of super top-up health insurance?

Age, pre-existing medical conditions, coverage limit, and deductible amount mainly affect the premium of super top-up health insurance. The older an individual is, the higher the premium. Pre-existing medical conditions, if any, can also increase the premium. Higher coverage limit and lower deductible amount come at a higher price, and vice versa.

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