A top up health policy is an additional coverage for people who have an existing individual plan or a mediclaim from the employer. Unlike the regular top-up health insurance plan that only covers claims when a single claim surpasses the threshold limit, the super top-up plan covers claims when the overall claims during the policy period are above the threshold limit
With Top up - If you have a base plan of Rs 5 lakhs & have a top up of Rs 10 lakhs Thus, the total sum insured amount is Rs 15 lakhs with a threshold/deductible limit of Rs. 5 lakhs. If you have been hospitalized 3 times in a year with bills of 2 Lakhs each during each hospitalization which is 6 Lakhs, the top up will NOT get triggered and the balance of 1 Lakh may have to be borne by the customer
With Super Top up - If you have a base plan of Rs 5 lakhs & have a SUPER top up of Rs 10 lakhs Thus, the total sum insured amount is Rs 15 lakhs with a threshold/deductible limit of Rs. 5 lakhs. If you have been hospitalized 3 times in a year with bills of 2 Lakhs during each hospitalization which is 6 Lakhs, the top up will get triggered for the balance of Rs 1 Lakh
Note that the threshold limit is NOT considered for every claim in the super top-up plans but rather on the total hospitalization bill during the policy period (cumulative claims). However, in the case of a top-up plan, the plan will only turn active if the medical bill crosses the threshold limit for each claim