6 Important Tips To Keep In Mind When You Buy A Super Top-Up

Super Top-Ups - Some Handy Tips!

A Super Top-Up is a separate health cover with its own limitations and conditions. Avoid any hassles in the future by staying aware of the following factors -

• Separate Claims

  Once you buy a super top up, you will now own two health insurance policies - your base plan and a super-top up. Enter two different application processes and different claim processes.

  Check our article on from 2 different health insurance policies.

  A Super Top-up can be purchased from either the same insurer or a different insurer. Getting it from the same insurer will simplify the process as the claim will be processed seamlessly.

• Different Cashless Networks

  There's a chance that if you have bought a Super Top-up Plan from a different insurance company, network hospitals that allow cashless payment may be completely different from the one offered by your base plan. Make sure you examine the hospital list carefully.

• Fewer Benefits

  The features of a Super Top-up plan may be limited as compared to a standard health insurance plan. Super Top-ups also have a room rent limit - a limit up to which your insurance company will bear the hospital room rent, or Super Top up may not cover say Organ donor expenses or Day care treatments. Take the time to carefully review all features and benefits before you commit to the plan.

• Different Waiting Periods

  There might be a difference in the pre-existing waiting period of your super top-up and the base plan. A waiting period is a time period during which some specified conditions are not covered by the policy. Generally, the waiting period for pre-existing diseases is 2-4 years. Be aware of the differences, so you don't get caught off guard.

• Super Top-Up v/s Upgrading Your Existing Plan - Which Is Better?

  While having one plan with a large cover can be extremely convenient, super Top-ups are extremely affordable when compared to normal health plan upgrades and hence make a compelling proposition. In the long run, they can provide you with quality health insurance coverage at a reasonable cost. A Super Top-up coupled with your base plan is the most effective way to purchase health insurance.

  The first step is to have a sufficient base cover to take care of smaller hospitalisation expenses without having to worry about room rent limits or quality of medical treatment. As a result, you should allocate Rs 10 lakhs for your family. You can extend your coverage by adding a super top-up plan that is affordable.

  It is possible to choose from a variety of top-up options, such as 10 lakhs, 15 lakhs and 25 lakhs etc. In case a serious hospitalisation is needed, this extended coverage helps bear a large portion of the cost.

• When To Buy A Super Top-Up?

  As discussed before, Super Top-Ups come with a deductible, i.e., they activate when a certain amount is crossed. The deductible is calculated on a yearly basis.

  In other words, your hospitalisation expenses should exceed the deductible amount during the year in question for the Super Top-Up to pay.

  In order to get the most out of your Super Top-Up, it is best if you can purchase it in the same month as your base-plan, or on the same day. Claim payments can be complex if the months do not line up.
   

Here's an example to understand the above point -

Bharat has a combo plan - A Base Health Insurance Plan and a Super Top-up Plan

The base plan of Rs 5 Lakhs with plan year - January 2022 to December 2022.

Super Top-Up of Rs 10 Lakh with an annual deductible of Rs 5 Lakh for the period March 2022 to February 2023.

To qualify for the Super Top-Up, the hospitalisation expenses must exceed Rs 5 lakhs during the policy period, March 2022 to February 2023.

Let’s Assume Bharat Undergoes Two Hospitalizations In 2022.

What Happens During The Second Claim?

Since Barat has exhausted the cover amount available for the year for his first surgery, he can't claim for the second one.

Barat can’t use his Super Top-up cover because it only pays when the hospitalisation expenses between March 2022 and February 2023 cross the deductible of Rs 5 lakhs. Since the first hospitalisation happened in February 2022, it doesn't fall under the Super top-Up term. Hence, the first hospitalisation expense, i.e., Rs 5 lakhs shall not be considered a deductible.

According to this claim, the total hospitalisation expenses during the particular period of April 21 to March 22 are only Rs 2.5 lakhs (below Rs 5 Lakhs). Thus, the claim will be denied.

What is The Best Course of Action?

The answer is pretty easy. Buy your Super Top-Up on the same day as your base plan or as close as possible to that date. In this way, your deductible will be calculated concurrently with your base plan calculation - ensuring you have ample coverage.

Summing Up!

A Super Top-up keeps you prepared and saves you from financial straits, when your health insurance policy doesn’t cover you adequately - especially in emergencies! Make sure you go through these conditions carefully and read the plan thoroughly, so you’re in for no surprises down the road.