A health insurance policy serves as a protective measure in case of a medical crisis. A top-up health insurance policy enhances the coverage limit beyond the primary medical insurance policy at an affordable price. There exist two categories of top-up health insurance plans — regular and super top-up plans.

A regular top-up plan provides extra coverage that exceeds the deductible or threshold level of the current health insurance plan. It addresses only one claim above the deductible annually. If the hospital expenses do not surpass the deductible, the top-up health insurance will not become applicable.

On the other hand, a super top-up plan delivers additional coverage beyond the deductible amount and accommodates multiple claims for cumulative medical expenses exceeding the deductible amount within a year. A super top-up plan guarantees that the policyholder can receive medical treatment without any restrictions.

How Does the Deductible in Super Top-Up Health Insurance Function?

A deductible in super top-up health insurance signifies the amount the policyholder is required to pay from personal funds before the insurance company begins to cover medical costs. The deductible is applied each policy year and is usually lower than that of a conventional health insurance policy. Once the deductible is fulfilled, the insurance takes care of further hospitalization expenses, providing enhanced coverage at a more economical premium.

This kind of plan is perfect for individuals who already have health insurance, as it offers supplementary protection without significantly raising premiums. It aids in managing substantial medical expenses, especially for serious illnesses or surgical procedures.

Why Should You Choose Deductibles in Health Insurance?

Selecting deductibles in health insurance can greatly lower your premium expenses. By opting for a higher deductible, you agree to pay a specified amount out-of-pocket before the insurance covers your medical expenses. This makes your health insurance more budget-friendly, as the insurer assumes less risk.

Deductibles are suitable for those who are healthy and not expected to need regular medical treatment. They provide a balance between cost-efficiency and coverage, making them a smart option for individuals looking to control their healthcare expenses while remaining protected against major medical issues.

What Is Deductible in Super Top-Up?

Deductibles are the cost-sharing obligation imposed by the health insurance provider. In simple terms, deductibles are the fixed costs that the policyholder must incur before the insurer starts paying. Deductibles assist health insurance providers in distributing costs with the policyholder. When a policyholder acquires the super top-up health insurance plan, they can select a specific deductible amount.

For example, Ms. Kaur acquires a medical insurance policy valued at INR 3 lakhs. One day while discussing with her sister, Ms. Singhania, they talked about medical inflation. This raised concerns for Ms. Kaur about whether her coverage would be sufficient for future emergencies. Instead of increasing the base policy and paying a higher premium, her sister suggested she buy a super top-up plan of INR 7 lakhs.

The super top-up health insurance plan will activate only if the hospitalization bill exceeds the deductible amount. Ms. Kaur chose a deductible of INR 3 lakhs. In her situation, in addition to the medical insurance premium, she pays INR 3 lakhs as the deductible amount for the super top-up health insurance policy.

Later, Ms. Kaur requires heart surgery, and her hospitalization bill reaches INR 5 lakhs. Since the bill surpasses the deductible, INR 3 lakhs is covered by her regular medical insurance, and the remaining INR 2 lakhs is covered by the super top-up plan. Within six months, she is hospitalized again, and the bill is INR 4 lakhs. The base policy pays INR 3 lakhs, while the super top-up covers INR 1 lakh. As a result, Ms. Kaur doesn’t need to pay anything extra from her own funds.

Conclusion

If you possess a basic health insurance or mediclaim policy, it is advisable to acquire a super top-up health insurance policy. In a regular top-up plan, the deductible is applied to each claim. However, in a super top-up health insurance plan, the deductible applies to the total medical expenses incurred within a year.

The deductible amount can vary based on the selected policy. Some insurers also allow coverage up to 70 years of age under a single sum insured for the entire family. Benefits may differ depending on the insurance provider.

FAQ

1. Which health insurance policy is recommended for the family floater plan and has a sufficient deductible amount?
The Bajaj Allianz Extra Care policy offers coverage between INR 10 lakhs to INR 15 lakhs, with a deductible ranging from INR 3 lakhs to INR 5 lakhs. It includes a family floater medical insurance plan, and thus, it operates on a per-claim basis.

2. When does the super top-up health insurance policy expire?
The super top-up health insurance policy expires when the entire amount is exhausted, as it accommodates multiple claims within the policy year.

3. What is the deductible in health insurance super top-up?
The deductible in a super top-up plan is the amount you need to pay out-of-pocket before the insurer begins covering medical expenses. Once the deductible is met, the policy provides additional coverage for hospitalization and treatment expenses.