Top-up Health Insurance Plans

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.
Top-up Health Insurance Plans
3 mins
13-April-2023

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 on the basis of your current needs and the premium. It is very possible that you realise 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 a nominal price. A top-up health insurance plan gives an extra cover to you if your regular health insurance plan’s coverage gets exhausted.

What is top-up health insurance?

Top-up health insurance is a supplemental health insurance plan that provides additional coverage beyond the threshold limit of an existing policy. It is designed to provide additional protection to individuals who may require medical treatment beyond the amount covered by their primary health insurance policy.

A top-up health insurance policy is beneficial as it offers higher coverage at an affordable premium. It provides financial support in case of unexpected medical emergencies or illnesses that require higher medical expenses. With the rising cost of medical treatment, a top-up policy is a wise investment in ensuring adequate healthcare coverage for oneself and their loved ones.

In India, top-up health insurance policies are gaining popularity due to their cost-effectiveness and comprehensive coverage. Insurance providers offer various top-up policies with different features and benefits, allowing individuals to choose a plan that best suits their healthcare needs and budget. It is advisable to compare and research various top-up health insurance policies before making a decision.

How does top-up health insurance work?

As mentioned above, top-up health plans offer additional coverage beyond the threshold limit of an existing health insurance policy to policyholders. For example, an individual has an existing health insurance policy with coverage up to Rs. 3 lakh. They can purchase a top-up policy with coverage up to Rs. 5 lakh. If the individual incurs medical expenses of Rs. 4 lakh in a year, their primary policy will cover up to Rs. 3 lakh and the top-up policy will cover the remaining Rs. 1 lakh.

Basically, top-up health insurance works as a financial backup plan, providing adequate healthcare coverage during medical emergencies. Also, check super top-up health insurance available in India.

Read more: Super Top-up Health Insurance

Key benefits of top-up health insurance plans

Here are some key benefits of top-up health insurance plans.

In-patient hospitalisation treatment coverage

Get 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.

Affordable premiums

Top-up health insurance offers additional coverage at a much lower cost than regular health insurance.

No restrictions on coverage limits

Unlike basic health insurance, top-up insurance has no restrictions on coverage limits. This means that you can choose the amount of coverage you require based on your individual needs. Top-up health plans usually do not have sub-limits or restrictions on hospitalisation expenses like room rent, or doctor fees, etc.

Easily convertible

You can easily convert top-up health insurance into a regular health insurance policy if and when required.

High coverage at an 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 from 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.

Check what is health insurance and its types.

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.

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


How to apply for online 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 is processed successfully.

Inclusions and exclusions of top-up health insurance plans

Here’s a quick look at the key inclusions and exclusions of top-up health 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 where 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 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 for top-up health insurance:

  • 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.

What is the premium for top-up health insurance?

The premium for top-up health insurance depends on various factors such as age, medical history, sum insured, and deductibles. It is usually lower than the premium for a regular health insurance policy as it provides coverage beyond the threshold limit of an existing policy. It is important to compare top-up policies offered by different insurance providers before purchasing one.

What is a top-up plan?

A top-up plan is a type of health insurance policy that provides additional coverage for medical expenses at an affordable premium. It offers coverage for expenses not covered under regular health insurance policy or if you require additional sum insured. You can also convert a top-up plan into a regular policy when necessary. It is a useful tool to increase your coverage limit without increasing your premiums.

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Disclaimer

Bajaj Finance Ltd. (BFL) is merely a distributor of third party products from Assistance Services providers such as CPP Assistance Services Pvt Ltd, Bajaj Finserv Health Ltd.(BFHL), AWP Assistance India Pvt. Ltd. (Allianz), Doc Online Health India Pvt Ltd. etc. Issuance of the product is at sole discretion of Assistance Company or Services provider . The product and services or benefits assured under the product shall be governed by respective partner’s product T&C’s and BFL does NOT hold any responsibility for the issuance, quality, serviceability, maintenance and any claims post sale. Your purchase of an assistance product is purely on a voluntary basis after your exercise of an independent due diligence on the suitability, viability of any product. For more details on terms and conditions, inclusions and exclusions please read the product sales brochure carefully before purchase or subscription. All product information such as membership fees, benefits, exclusions, value added services, etc. are authentic and solely based on the information received from 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.