Top-up health insurance

A top-up health insurance plan is an additional health insurance policy you can buy with your existing health insurance plan. Here’s how you can buy the best top-up health plan as per your needs.

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3 mins
13-April-2023

What is Top-Up in Health Insurance?

Top-up health insurance policies give an extra cover to your regular health insurance policies. If the sum insured on your health insurance policy gets exhausted, you can get coverage for additional treatment with top-up health insurance policy. Anyone who has gone through a medical emergency knows that it leaves one with no time to think and can easily set you back financially. Hence it is very important to have sufficient health insurance coverage. But how do you know if your cover is sufficient? When you buy health insurance, you roughly estimate the sum insured basis your current needs and the premium. It is very possible that you realise in over time that you may need higher cover but cannot pay a higher premium.
At such times, purchase a top-up health plan to enhance your health insurance policy’s limit at nominal price. A top-up health insurance plan will cover the additional expenses if your regular health plan coverage gets exhausted.

Key benefits of top-up health insurance plans

· In-patient hospitalisation treatment coverage

Policyholders can benefit from financialGet coverage on charges incurred during hospitalisation for treatments, tests, or other medical procedures. It includes the medical expenses, but the room rent capping depends on the insurance provider.

· Pre-and post-hospitalisation coverage

You may incur a few medical expenses before hospital admission and after discharge. These include diagnostics tests, such as angiograms, X-rays, MRIs. Also, medication needed before and after hospitalisation. Top-up health insurance covers these charges up to 60 days before and 90 days after hospitalisation. The duration may differ from insurer to insurer.

· Organ donor expenses coverage

Donors feel reluctant to come forward as they must cover their medical expenses. With a top-up health insurance plan, you can steer clear of this major deterrent. It covers the surgical and medical costs associated with harvesting a critical organ transplant of the insured.

· Emergency ambulance coverage

You no longer have to pay for emergency ambulance charges if your health insurance does not cover it. With a top-up plan, you get the sum insured as per the insurance purchased.

· High coverage at affordable premium

Get additional coverage over and above your health insurance policy. Top-up health insurance plans come with higher coverage at affordable premiums.

· Tax benefit

Get tax rebate for the premium paid towards the top-up health insurance policy. You can file for tax exemption under the relevant sections of the Income Tax Act.

· Covers pre-existing illnesses

Many top-up health insurance plans cover pre-existing diseases. Usually, you get to benefit the coverage after a waiting period. Most insurers apply a waiting period of 2 to 4 years on the pre-existing diseases. During this period, you cannot claim for the benefits if you undergo any treatment for the pre-existing illness. The conditions vary from insurer to insurer.

What are the types of top-up health insurance plans?

You get top-up health insurance in two forms. One, a simple top-up health plan and another, a super top-up health plan. Both these types work as a booster to your primary health insurance plan. You can use these plans to pay the additional medical expenses if your regular health plan gets exhausted.

Top-up vs. super top-up health insurance plan

Below is a quick read to know the difference between top-up and super top-up health insurance plans

Top-up health plan

Super top-up health plan

You can claim once in a policy term.

You can claim multiple times in a policy term.

The plan will lapse immediately after you claim the benefit once.

The plan will lapse after the entire claim limit gets over.

Premium for top-up health insurance plan is low.

Premium for super top-up health insurance plan maybe a bit higher than a top-up health insurance plan.


Inclusions and exclusions of top-up health insurance plans

Here’s a quick look at the key inclusions and exclusions of top-up medical insurance plans.

Key inclusions of top-up health insurance plan

• Covers all necessary medical expenses.
• Covers room rent expenses during hospitalisation.
• Covers pre-and post-hospitalisation expenses up to 30 to 60 days.
• Covers organ donor expenses if needed an organ transplant.
• Covers daycare procedures wherein you need to get hospitalised for less than 24 hours.
• Covers ambulances charges up to a specified limit, depending on the insurer.

Key exclusions of top-up health insurance plan

• No coverage given for undeclared pre-existing diseases.
• Does not cover self-inflicted injuries.
• Does not cover cosmetic surgery if medically not necessitated.
• Does not cover treatment for sexually transmitted diseases.

How to apply for top-up health insurance plans

Step 1: Click here to open our online application form.

Step 2: Fill in the application form with your basic details or the person whom you want to insure. Provide name, gender, mobile number, date of birth, and residential PIN code.

Step 3: Now click on ‘Get Quote’ to proceed.

Step 4: From the list of policies shown, choose your preferred top-up health insurance plan by clicking the ‘Buy Now’ button placed under each plan. You can further modify the insured amount, policy term, and plan-type to get a list of policies tailored to your preference.

Step 5: Based on the plan you choose, you may get the option to select the policy term and premium amount.

Step 6: Enter your email ID and check if all personal details shown are correct. Click ‘Next’ to proceed.

Step 7: Enter some additional details, such as height, weight, nationality, marital status, address, and nominee details (if applicable).

Step 8: Answer a few questions about your health and lifestyle by clicking the relevant checkboxes. Click on the ‘Next’ button to proceed.

Step 9: Verify if the previously filled details are correct and click on the ‘Proceed’ button to visit the payment page.

Step 10: Make the payment through net banking, UPI, debit, or credit card to buy the policy.

After successful payment, your policy document will be available for you to download instantly. You will receive a copy of the policy document on your registered email ID within 5 to 7 working days.

You will also receive an SMS confirmation immediately after the payment processed successfully.

You can also access your policy details through the My Account section within 5 to 7 days after purchase.

How to raise a claim against your top-up health plans?

Policyholders must keep all receipts arranged while raising a claim against their top-up health insurance. Below is the step-by-step guide to filing a claim with the company:

Cashless claim

Follow the steps to file a cashless claim for treatment at a partner network hospital anywhere within India:

  • Look for a partner network hospital in the city to avail the cashless treatment.
  • Inform the insurer 72 hours before the admission for planned hospitalisation. In case of an emergency, inform within 48 hours of hospitalisation.
  • Carry the patient’s insurance cashless card or policy details.
  • Show the health insurance cashless card and valid ID proof at the insurance desk of the hospital.
  • Fill the pre-authorisation request form available at the hospital and submit it to the concerned authority.
  • You can also fill the form online on the official website and inform your insurer for quicker response.
  • Your insurer may take up to 2 hours to review. Insurer will send an SMS or email to inform you about the decision. You can check the status of your cashless claim online.
  • After completing the formalities, your insurer will process your claim according to the terms and conditions.

Reimbursement claim

Follow the steps to file a reimbursement claim at a partner network hospital anywhere within India:

  • You need to inform the insurer within 48 hours in case of any emergency admission. Then pay the charges at the hospital if the insurer has not issued a pre-authorisation.
  • Submit all the necessary documents within 15 days of discharge from the hospital.
  • Your insurer may approve or reject your claim according to the policy terms and conditions.
  • The insurer will transfer the reimbursement amount to your registered bank account if your claim gets approved.
  • If your claim gets rejected, insurer will inform on your registered contact number and email address.
  • Adding a top-up health insurance plan enhances your health coverage amid increasing healthcare costs. Having a top-up health plan makes perfect sense even if you have an existing individual or group health insurance policy.

Frequently asked questions

What is the difference between top-up and super top-up?

Top-up and super top-up health insurance plans give you and extra health coverage over and above your existing health insurance plans. It helps if you end up exhausting the sum insured on your regular health insurance plan during a medical emergency. Top-up plans cover additional medical expenses up to the threshold limit. You can claim only once in a policy term under the top-up health plan. Super top-up health plans cover medical expenses beyond the threshold limit of the insured amount. You can claim multiple times in a policy term.

Why do I need super top-up health insurance?

Super top-up health insurance plans enhance your base health plan with additional coverage. It benefits especially when the sum insured on your regular health insurance plan gets over. During such medical emergencies, it acts as an extra coverage. So, you can focus on the treatment without worrying about the funds.

What are the benefits of top-up insurance?

Bajaj Finance offers the following benefits under the top-up health insurance plans:
1. Pay your deductible amount for once only.
2. Get cashless facilities at network hospitals of our insurance partners.
3. Covers hospitalisation, pre-and post-hospitalisation, medicines, and more benefits.
4. Easy online application and claim process.

Disclaimer

Insurance is the subject matter of solicitation. Bajaj Finance Limited (‘BFL’) is a registered corporate agent of third party insurance products of Bajaj Allianz Life Insurance Company Limited, HDFC Life Insurance Company Limited, Future Generali Life Insurance Company Limited, Bajaj Allianz General Insurance Company Limited, SBI General Insurance Company Limited, ACKO General Insurance Limited, Niva Bupa Health Insurance Company Limited , Aditya Birla Health Insurance Company Limited and ManipalCigna Health Insurance Company Limited under the IRDAI composite CA registration number CA0101. Please note that, BFL does not underwrite the risk or act as an insurer. Your purchase of an insurance product is purely on a voluntary basis after your exercise of an independent due diligence on the suitability, viability of any insurance product. Any decision to purchase insurance product is solely at your own risk and responsibility and BFL shall not be liable for any loss or damage that any person may suffer, whether directly or indirectly. Please refer insurer's website for Policy Wordings. For more details on risk factors, terms and conditions and exclusions please read the product sales brochure carefully before concluding a sale. Tax benefits applicable if any, will be as per the prevailing tax laws. Tax laws are subject to change. Visitors are hereby informed that their information submitted on the website may be shared with insurers. BFL is also a distributor of other third-party products from Assistance Services providers such as CPP Assistance Services Pvt Ltd, etc. All product information such as premium, benefits, exclusions, sum insured, value added services, etc. are authentic and solely based on the information received from the respective insurance company or the respective value-added service provider or Assistance company.

Note – While we have made all efforts and taken utmost care in gathering precise information about the products, features, benefits, etc. However, BFL cannot be held liable for any direct or indirect damage/loss. We request our customers to conduct their research about these products and refer to the respective product’s sales brochures before concluding their sale.