Advancement in medical treatment and inflation has led to steep rise in health care expenses. Even for those who have health insurance cover, the Sum Insured becomes insufficient over time due to rising healthcare costs. It is not feasible to buy multiple health policies due to high costs and manageability. The most economical and efficient way to boost your health cover is by either Top Up Policy or Super Top Up Policy. These policies provide health cover above a threshold limit known as ‘Deductible’ in the policy.
Difference between Copay and Deductible
You can claim from these policies after your hospitalization expenses exceed the deductible limit specified. You can pay the medical expenses up to the deductible limit from your own pocket or through a regular health insurance cover. Such policies are also referred to as ‘Stepney’ health cover.
Because of the deductible, the premiums of these policies are cheaper and the Sum Insured is higher. These policies are available as both individual and family floater policies. It is a very cost-effective way to increase the health cover for your parents and senior citizens whose health care costs are high.
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Top Up Plans Vs Super Top Up Plans
In Top Up plans, the deductible limit is applicable for each and every case of hospitalization in a year. The claims are admissible only if the cost of every case of hospitalization in a year, exceeds the deductible limit.
In Super Top Up plan, the deductible limit is calculated as the aggregate of the total cost of all hospitalizations, in a given year. If in a given year the cost of hospitalization exceeds the deductible limit once, then the policy covers the cost of all further hospitalization in that year.
Let us consider an example to understand how these policies fare against each other.
Mr. Nikhil wants to buy either a Top Up or Super Top Up policy with Sum Insured of Rs.10 lakhs with a Rs.3 lakhs deductible. Let us consider a case when Nikhil has to get hospitalized thrice in a year.
| Top Up Policy | Super Top Up Policy | |
| Deductible | Rs.3 lakhs | Rs.3 lakhs |
| Sum Insured | Rs.10 lakhs | Rs.10 lakhs |
| 1st hospitalization claim | Rs.5 lakhs | Rs.5 lakhs |
| Nikhil pays | Rs.3 lakhs | Rs.3 lakhs |
| Insurer pays | Rs.2 lakhs | Rs.2 lakhs |
| 2nd hospitalization claim | Rs.7 lakhs | Rs.7 lakhs |
| Nikhil pays | Rs.3 lakhs | Rs.0 |
| Insurer pays | Rs.4 lakhs | Rs.7 lakhs |
| 3rd hospitalization claim | Rs.2 lakhs | Rs.2 lakhs |
| Nikhil pays | Rs.2 lakhs | Rs.0 |
| Insurer pays | Rs.0 | Rs.2 lakhs |
If you analyze the above example, Super Top Up Plans have a definite advantage over Top Up Plans as they do not consider the deductible limit for each and every case of hospitalization.
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