12 Jul, 2021 | Health Insurance

Topups or Super Topups - Which is better to boost health insurance coverage?

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Will your current health insurance cover be enough ten years down? What about twenty? Surely not. And given you’ll not be able to upgrade your policy once you make your first claim, it is necessary that you buy sufficient cover for your long-term future, today. 

But direct health insurance upgrades can be very costly, and many families settle for a low sum insured, just because they can’t afford them. But, there are options to get around this.

Topups and Super Topups. 

Topups and Super Topups are extensions to your base health insurance plan that can help you get a higher sum insured at a reasonably low cost. Each extension comes with a ‘deductible’ - which is the amount after which these plans start paying. Usually, you match the deductible to your base-plan amount, so, as soon as the base-plan is exhausted, (or the deductible is crossed) the extension comes into play. These plans can be bought from the same insurance company where your base plan is bought or any other. 

While they sound similar, Topups and Super Topups can be very different in terms of how they pay. Let’s go through them one-by-one. 

First - Topups. 

A Topup’s deductible is calculated based on every single hospitalisation. That means that it becomes active and starts paying only if the expenditure on one, single hospitalisation crosses the deductible limit. 

Let’s take an example and explain this better. Consider this combination. 

  • Base-plan INR 5 Lakhs. 
  • Topup INR 10 Lakhs (with a deductible of 5 Lakhs)

Consider these hospitalisations over the period of a year. 

1️⃣ Hospitalisation 1: Claim amount = 3 Lakhs 

This is paid entirely by the base plan. 

2️⃣ Hospitalisation 2: Claim amount = 3 Lakhs

Of this, the base plan pays the available 2 lakhs. 

But, since this particular hospitalisation’s cost is not beyond the Topup’s deductible of 5 lakhs, the remaining amount of 1 Lakh will need to be paid out of your pocket. 

3️⃣ Hospitalisation 3: Claim amount 7 Lakhs

Of this, the first 5 Lakhs will need to be paid out of your pocket.

With that, the deductible is met - and the Topup will pay the remaining 2 Lakhs. 

Summing up in this table. 

 Claim amountInsurance paysYou payWhich plan covers?
Hospitalisation 13 Lakhs3 Lakhs0Base plan
Hospitalisation 23 Lakhs2 Lakhs1 LakhBase plan
Hospitalisation 37 Lakhs2 Lakhs5 LakhsTopup plan


 

Total claims made in the year = 13 Lakhs

Paid by you = 6 Lakhs 

So you see, a Topup helps you out in cases of large hospitalisations - but, you might end up paying a large sum of money out of your own pocket, in most cases. 

So - we come to the next option - Super Topups.

A Super Topup’s deductible is calculated based on the sum total of all hospitalisation expenses incurred during the entire plan-year. Once the sum of costs paid across admissions crosses the deductible - your Super Topup starts paying. 

Let’s understand from the same example above, if you had bought a Super Topup instead. 

  • Base-plan INR 5 Lakhs. 
  • Super Topup INR 10 Lakhs (with a deductible of 5 Lakhs)

Consider these hospitalisations over the period of a year. 

1️⃣ Hospitalisation 1: Claim amount = 3 Lakhs 

This is paid entirely by the base plan. 

2️⃣ Hospitalisation 2: Claim amount = 3 Lakhs

Of this, the base plan pays the remaining 2 lakhs. 

Now - note the difference. 

The total deductible of 5 Lakhs is achieved across two hospitalisations, hence the Super Topup kicks in and pays the remaining 1 lakh.

3️⃣ Hospitalisation 3: Claim amount 7 Lakhs

Since the deductible has already been met during the plan-year, the Super Topup pays all the 7 lakhs in this admission. 

Summing up in this table. 

 Claim amountInsurance paysYou payWhich plan covers?
Hospitalisation 13 Lakhs3 Lakhs0Base plan
Hospitalisation 23 Lakhs

2 Lakhs +

1 Lakh

0Base plan + Super Topup
Hospitalisation 37 Lakhs7 Lakhs0Super Topup plan



 

Total claims made in the year = 13 Lakhs

Paid by you = 0

Topup or Super Topup - Which one should you pick?

Generally, advisors suggest a Topup if they see that you do not have any major health issues, or don’t expect to have them in the future. And Super Topups if you’re at a higher risk of chronic illnesses, requiring multiple hospitalisations in the future. Topups are considerably cheaper than Super Topups - so that’s seen as a way to save some money. 

But honestly, given our lifestyles, stress and poor eating habits - this is very difficult to predict. Plus - there’s always the risk of accident-related hospitalisations which can happen to anyone at any time! 

One thing to note is that when you have hospitalisations with large bills in each of them, both Super Topups and Topups work in the same way. The major difference comes in when you have several, smaller bills - where Topups can become pretty useless. 

On the other hand, with a Super Topup - it doesn’t matter whether you undergo a single or multiple hospitalisations, it will pay as long as the deductible is paid for - and hence it is a better option. 

Summing up, without having to directly upgrade your health insurance, you can use Topups and Super Topups to extend the cover amount. These start paying as soon as the base-plan is exhausted - and can provide a considerably large cover for an affordable cost. 

Now that you have a basic understanding of how Topups and Super Topups work - you should read this article - with a detailed insight into the nuances that come into play with these extension plans - including waiting periods, cover restrictions such as room rent limits, complex claim procedures, etc. Make sure you’re aware of all these limitations before you buy a plan. 

Key takeaways
  1. Topups and Super Topups are extensions that you can buy on your base health insurance cover.
  2. Compared to directly upgrading your existing health insurance plan, Topup and Super Topup plans are a more cost-efficient way to upgrade your policy.
  3. Both these plans come with a deductible limit. 
  4. For a Topup to become active, every single time you’re hospitalized, your claim amount should go above the deductible limit.
  5. A super top-up pays for each hospitalization once your claim crosses your deductible limit on an aggregate basis in a given year.
  6. A Super Topup plan costs more than a Topup plan. However, it is a better option because it will pay for both single and multiple hospitalizations once your expenses cross the deductible limit.
Team Beshak
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Team Beshak, We breathe insurance :)

We are a group of young members of the Beshak community. We come together to brainstorm, write relevant and useful content for people (just like us) who want to figure insurance on their own. If you too want to share inputs/write for us - send us a "hey" to info@beshak.org

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