Top-up Health Insurance

Serving as a supplement to the health insurance coverage you already have, top-up health insurance offers an excellent way to enhance it. On Bajaj Markets, you can get top-up insurance from leading issuers with premiums starting at just ₹160 per month.

Get financial support towards medical expenses over and above the sum insured of your regular health policy with top-up health insurance. It is also an ideal solution if you are near to or have already exhausted your existing coverage. 

 

These plans may seem similar to some riders, such as:

• Critical Illness

• Hospital cash

• Personal Accidental Cover

 

However, the key distinction is that riders offer coverage for specific issues or facilities. 

A top-up facility offers overall enhancement of your coverage. In addition, you get tax benefits when you add a top-up plan to your base insurance, too.

This plan becomes effective only after you exhaust the sum insured of your current policy. Once you get the insurance, you must select the compulsory deductible amount and pay it before accessing the benefits of the top-up.

 

You can address the deductible amount either from personal funds or through a base health insurance policy. Before you proceed, keep two things in mind:

• You can only claim the benefits from the top-up insurance plan once within a policy year

• To claim the top-up cover, a single medical bill needs to cross the deductible amount 

 

Here is an example that will help you understand how top-up health insurance works. Say you have a health cover worth ₹6 Lakhs. Later, you realise that ₹6 Lakhs may not be sufficient for you, and you want to increase the limit by ₹4 Lakhs. 

 

In this scenario, you can purchase a new health insurance policy with a cover of ₹4 Lakhs or get a top-up cover of ₹4 Lakhs on your current insurance. Choosing the latter will be cost-effective as the premium amount will be lower as compared to getting a new policy.

After assessing your requirements and affordability, decide on the top-up coverage that seems adequate. Choosing a top-up health insurance is ideal in the following scenarios:

• When you have exhausted the coverage provided under your current health insurance

• If you anticipate high medical expenses due to the diagnosis of new diseases or illnesses

• If you wish to increase your health coverage to keep up with the rising inflation

• When you want to increase your coverage to protect yourself from unforeseen medical expenses

Here is an overview of the top-up health insurance plans you can explore:

Disclaimer: The details mentioned above are indicative and are subject to change based on the policy and insurer’s terms.

Here are some top advantages of getting a top-up health insurance:

Extra Coverage

Top-up health insurance plans are a great way to get a financial backup for your regular insurance. These come to your aid when your existing cover is insufficient or exhausted. 

No Medical Test Required

Most insurers do not require you to undergo a medical exam if you are up to a certain age, which is 55 years in most cases. This makes this plan easy to get. 

High Coverage at Low Premiums

Top-up health insurance is generally more affordable than a new individual plan. Use a premium calculator to compare various top-up plans and ensure you get the most affordable one.

Tax Benefits

Another significant advantage is that these plans are eligible for deductions under Section 80D of the Income Tax Act of 1961.

Easy Conversion 

Many insurance companies offer the facility of converting your top-up plan into a comprehensive health insurance plan at the time of renewal. 

No Claim Bonus

You benefit from this feature for every claim-free year till the end of your policy tenure even on top-up plans. 

Choose a plan keeping in mind that this policy generally covers the following expenses:

In-Patient Hospitalisation

These expenses include:

• Cost of the hospital room

• Doctor’s fees

• Nursing charges

• Cost of oxygen tanks

• OT charges

• Implants added during surgeries

Pre- and Post-Hospitalisation Expenses

Top-up health insurance also covers hospital expenses incurred before and after the hospitalisation, such as:

• Diagnosis

• Medicine expenses

• Treatment charges

• Consultation fees of doctors 

Day Care Treatment

It also covers fees related to treatments where you are discharged from the medical institution within 24 hours. Common treatments include:

• Dialysis

• Chemotherapy

• Cataract surgery

Domiciliary Hospitalisation

Expenses related to treatment at home when you are unable to visit the hospital are also covered. 

Road Ambulance Expenses

The policy covers charges associated with ambulance services too. 

Treatments Under AYUSH

These policies also cover the expenses for alternate treatments under AYUSH, which include:

• Ayurveda

• Yoga

• Unani

• Siddha

• Naturopathy

• Homeopathy

Organ Donor Expenses

It also covers organ transplant costs that may include:

• Hospitalisation charges 

• Medicine costs 

• Organ transfer charges

Annual Health Check-ups

Most insurers cover the expenses of yearly lab tests. These include the following:

• Urine routine

• Blood sugar

• Kidney function

• Blood groups

• ECG

Maternity Expenses

Some top-up health insurance policies also cover maternity expenses, such as:

• Expenses incurred during delivery

• Pre-natal and post-natal expenses

• Caesarean expenses

• Room rent charges

 

The inclusions vary across insurers. Check these details because they determine what your out-of-pocket expenses may come to. 

Here are the key differences between top-up and base health plans:

While both add value to your base medical policy, super top-up health insurance may offer some additional advantages. Refer to this table to understand how. 

Here is an example that outlines their differences. Say the sum insured for both top-up health insurance and super top-up health insurance is ₹10 Lakhs, and the deductible amount is ₹2 Lakhs.

Here are some points you must keep in mind when selecting top-up health insurance:

Waiting Period

Top-up plans are considered separate health plans with distinct waiting periods. You may need to wait before you can claim medical expenses for pre-existing diseases or illnesses. Check it before finalising your plan.

Co-payment Clause

Just like regular health insurance, these policies also have co-payment clauses. This requires you to pay a portion of the medical expenses while the insurer will pay the remaining amount. 

 

Co-payment affects the premium with higher co-pay leading to lower premiums. It can also mean higher out-of-pocket expenses during health treatment. Be wary of this to make the right choice. 

Deductible

Top-up health insurance comes with a deductible, which you have to pay before filing a claim. You can pay this from your pocket or via your base health insurance. Compare plans to select one with an affordable deductible. 

Network Hospitals

While you can file cashless claims at network and non-network hospitals today, you may have a more seamless experience at partner facilities. Confirm if your chosen insurer has your preferred hospitals in its network before signing up. 

Inclusions and Exclusions

These determine when the insurer is liable to pay for your medical expenses. Ensure you check your top-up health insurance plan’s terms to be fully informed before you finalise it.