Here’s How A Super Top-Up Health Insurance Plan Can Enhance Your Existing Health Cover

One of the many things people usually ask is whether they can get a super top-up health insurance plan on their existing health insurance, based on their age, medical history and current health conditions.

Well, to put it plainly, the answer is yes.

That said, one should keep in mind a few points while going for a super top-up policy. Here they are:  

• It will have all the terms and conditions of starting a new health insurance policy, including the waiting periods (those that apply initially, for specifics and for existing diseases).  
• With individual health insurance, an individual super top-up policy is available; with floater health insurance, you will need to go for a floater super top-up policy.  
• One needs to have at least Rs 5 lakh-cover individually, and Rs 5 lakh multiplied by the number of members if it’s a floater plan. However, you can have higher cover depending on your income, lifestyle and paying capacity, and/or location.
• The existing health cover or lower can be considered as the deductible amount in the super top-up policy. 
• Ideally, take the super top-up policy from the same insurer from where you have the existing policy for reduced paperwork and co-ordination.  
• Do note that if you take the super top-up policy from another insurer, you may not get a cashless facility as the other Insurer may not have a tie-up with the specific hospitals. Only if it is not feasible to take a super top-up from the same insurer should you go to another company. Or, you can consider increasing the coverage in your existing policy. 
• Super top-up will be applicable once the deductible is exhausted during the policy period. Ideally, the super top-up policy issuance date should be on the policy anniversary of your existing policy. This is because of the way the deductible is considered for being eligible for a claim from the super top-up policy. 

 For example, let us take two scenarios. 

Scenario 1: You have an existing health insurance policy of Rs. 5 lakh.  

Now you have taken a super top-up policy of Rs. 20 lakh with a deductible of Rs. 5 lakh. This means that you will be able to claim from your super top-up policy only if there is a hospitalisation expense of more than Rs. 5 lakh during the policy period of your super top-up policy, with the first Rs. 5 lakh being paid by your existing insurance policy, or by you.  

So, if the policy period is the same for both the existing base health insurance policy and the super top-up policy, you will not have any problems during the claim, e.g., if there is a claim of Rs. 10 lakh during this policy period, the first Rs. 5 lakh will be paid out by the existing base insurance policy, and the remaining Rs. 5 lakh will be paid by the super top-up policy. 

Scenario 2: You have an existing health insurance policy of Rs. 5 lakh and its policy period is May 1, 2022 to June 30, 2023.  

However, let us say that you take the super top-up policy with a different policy period – Oct 1, 2022 to September 30, 2023 for Rs. 20 lakh with a deductible of Rs. 5 lakh.  

You have renewed both your existing health insurance policy of Rs. 5 lakh – May 1, 2023 to April 30, 2024 and super top-up – Oct 1, 2023 to Sept 30, 2024.  

Now, you have a claim of Rs. 5 lakh in May 2023, which is paid out by your existing health insurance policy, and there is no amount left to be claimed from this policy for the rest of the policy period – May 2023 to April 2024. Now you have another hospitalisation in Oct 2023 for which the bill is Rs. 2 lakh. Here, you will not be able to claim from your existing base health insurance policy, as it has already paid you Rs. 5 lakh in the earlier claim.  

And for the super top up policy – period Oct 1, 2023 to Sept 30, 2023, the deductible of Rs. 5 lakh is applicable starting Oct 1, 2023. It will not pay the first Rs. 5 lakh of hospitalisation claim during this policy period. So, now you will have to pay the bill of Rs. 2 lakh from your pocket.  

Hence, it is important to match the policy period of your super top-up policy with your base insurance policy.  

The author is a certified financial planner at Handholding Financials .

(Disclaimer: Views expressed are the author’s own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.)