Super top-up plans are similar to top-up plans, except that the top-up plan covers a single claim above the threshold limit. In contrast, the super top-up plan covers the total of all hospitalization bills above the threshold limit.
Scenario 1. What happens when a single bill of Rs. 8 lacs is generated?
Basic health insurance will pay Rs. 2 lacs. The balance of 6 lacs will be paid by the top-up plan. Since the single amount of the bill is less than the top-up value, there will be no difference between the top-up and super top-up plan. The difference arises if the expenditure happens in separate hospitalization charges, demonstrated herein.
Scenario 2: What happens when more than 1 bill is generated: 1) Rs. 6 lacs, 2) Rs. 2 lacs 3) Rs. 1 lac
Basic insurance will pay Rs. 2 lacs (the minimum amount covered). Top-up insurance will pay 4 lacs (as the amount of 1st bill is more than the threshold limit of Rs. 5 lacs), and the patient shall bare other expenses.
Basic insurance will pay Rs. 2 lacs, and super top-up will pay a balance of Rs. 4 lacs. Super top-up will also pay the following two bills of Rs. 2 lacs and Rs. 1 lac, since the total hospitalization expenditure exceeds the threshold limit of Rs. 5 lacs in that year.
Learn More about: Network hospitalization, Basic Sum Assured
Was this article helpful?
That’s Great!
Thank you for your feedback
Sorry! We couldn't be helpful
Thank you for your feedback
Feedback sent
We appreciate your effort and will try to fix the article