Top-Up Health Insurance Plans: 4 Important Things You Should Know

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Medically reviewed by

Bajaj Finserv Health

Aarogya Care

5 min read

Key Takeaways

  • You need a higher sum insured to cover rising medical expenses
  • Buy a top-up health plan if your existing coverage is not enough
  • Premiums you pay on top-up plans offer income tax benefits

Leading a stressful and sedentary lifestyle, people often tend to neglect their health and well-being. This leads to a rise in various ailments. Regular exercise, a healthy diet, and the right health insurance plan can put things in place. Health insurance protects your and your family’s health by covering unexpected and planned medical expenses. There are various health insurance plans including individual, family floater, group policy, and senior citizen health plans [1]. However, with the rising medical costs, it becomes unaffordable for many people to avail of treatments [2]. You require a bigger sum insured to cover the cost of treatment and services. Top-Up Health Insurance Plans proves beneficial during such times as it provides additional medical coverage above the sum insured of your regular health policy. Read on to know how to benefit from a top-up health insurance policy.

What are Top-Up Health Insurance Plans?

A Top-Up Health Insurance Plan is an indemnity policy providing additional coverage above the sum insured amount of your existing policy. This policy is activated when the existing sum insured on your base plan gets exhausted. Top-up health insurance gives you financial support by extending your maximum insurance limit. 

The premium on top-up insurance is more affordable and economical than the premium of a regular, comprehensive health policy. Remember that a top-up plan has a mandatory deductible, and you can avail the additional coverage benefit only after paying the deductible amount.

  • Example

Consider that you have a health insurance policy with a sum insured amount of Rs.10 lakh and you purchase an additional top-up plan of Rs.5 lakh. Now, several situations can occur. Suppose you claim an amount of Rs.7 lakh, your regular health policy will come into play. If you claim an amount of Rs. 12 lakh, Rs.10 lakh will be paid from your primary health policy and Rs.2 lakh will be paid from the top-up plan. If the claim amount is Rs. 18 lakh, both the sum insured amount of Rs. 10 lakh and the top-up benefit of Rs. 5 lakh will get utilized. In addition, you will pay the remainder of Rs. 3 lakh.Top-Up Health Insurance Plans inclusion

Additional Read: Super Top-Up vs Top-Up Health Insurance Plans

When should you opt for a top-up health policy?

Top-Up health insurance plan provides you with a higher coverage amount to cope with rising medical costs. Buying a top-up plan can help you in the following situations.

  • Your primary health insurance cover is not sufficient to meet your healthcare needs

In such situations, a top-up health plan will help you meet your health requirements.

  • You want a higher coverage amount at a lower premium
The premium charged on top-up plans is comparatively lower than buying a new health plan. You will save time and effort which you can spend on finding a new policy with similar benefits.

What are the features and benefits of top-up plans?

  • You can purchase a top-up plan even if you don’t have basic health insurance 
  • You can renew the top-up plans for a lifetime
  • You can easily convert a top-up plan to a basic health insurance plan
  • There are no limits and restrictions on hospitalization costs with top-up plans
  • You can get the benefit of a cumulative bonus for every claim-free year
  • The term of top-up policy can be up to 3 years depending on your insurer
  • You can avail top-up plans without medical checkups up to a specified age
  • You can buy top-up plans with individual health plans, family floater plans, and senior citizens health plans
  • You can purchase a top-up plan with an employer’s group health insurance scheme
  • Top-up plans come with a free look-up period of 15-30 days from the date of purchase of the policy
  • If you and your spouse are covered under a top-up plan, you can add your children too
  • There are no sub-limits on hospitalizations charges like doctor fees, room rents, etc.
  • Some top-up plans offer family discounts that include the policyholder, spouse, dependent parents, and children up to a specified limit
  • You can claim tax benefits for the premium paid on top-up plans under section 80D of the Income Tax Act [3]

Top-Up Health Insurance Plans: 4 Important -40

What are the things to consider while buying top-up health insurance plans?

Cost of purchasing

Analyze the costs before buying a top-up plan. Compare the premium and the benefits offered before making a final decision. You also need to compare its benefits with those of new health insurance policies. If the top-up plan is cost-effective and offers you better benefits than new policies, you can go for it.

Premium and deductible

Check the premium you need to pay for a top-up health plan. They usually have low premiums when compared to buying a new policy. However, it depends on the deductible you choose. A higher deductible lowers the premium and vice versa. So, choose your deductible limit and premium carefully.

Waiting period and other benefits

Do not forget to check the waiting period for pre-existing diseases on your top-up plan. Insurers have waiting period criteria that normally range from 2 to 4 years before covering the condition. 

For instance, if a new plan has a waiting period of 3 years and the top-up plan has a waiting period of 2 years, opt for the latter. Apart from these, check pre- and post-hospitalization coverage, maternity cover, deductible criteria for specific illnesses, and more. Also, find out if it provides coverage to your family members.

Additional Read: Factors Before Buying Health Insurance Policy For Family

Do not compromise on a high amount of health insurance coverage as it will help you tackle medical costs with ease. Consider buying Aarogya Care Health Plans offered by Bajaj Finserv Health. Get additional coverage of up to Rs.25 lakh and upgrade your health plan. Subscribe to the plan and get lab reimbursement of up to Rs.16,000 and doctor consultation benefits of up to Rs.6,500. That’s not all. No medical check-up is required to avail of these plans. Once you have compared all the plans, make an informed decision, and start protecting your health with the most suitable plan.

Published on 17 Jan 2022Last updated on 3 Jan 2023
  1. https://www.bajajallianz.com/blog/health-insurance-articles/types-of-health-insurance.html
  2. https://economictimes.indiatimes.com/the-rising-cost-of-medical-treatment-infographic/tomorrowmakersshow/69426281.cms
  3. https://www.incometaxindia.gov.in/Pages/tools/deduction-under-section-80d.aspx

Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.

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