Understand super top-up and how it works before you buy

Super top-up in health insurance can be a great asset for you. Make an informed decision with by understanding how it works

Super top-up is a feature by Pazcare that lets you do two things.

  1. Increases your insurance coverage 
  2. Allows you to add more people to the policy 

Super top is only available for Pazcare customers. You can use this feature only when your organization is offering group health insurance to you provided by Pazcare.

How does super top-up work?

Assume that your company is providing insurance worth 5 lakh only to employees. Parents or any dependents are not covered.

Case 1 - Increase premium

Your colleague Angad feels it is safe to have a bigger coverage. He can increase his coverage up to 20 lakhs using the super top-up feature and pay a small yearly premium.

Case 2 - Add members

Angad has parents (mom and dad) aged 52 and 53 respectively. His parents don’t have health insurance personally. But Angad is covered in the group health policy provided by your organization. Angad can easily add both his parents using the super top-up feature to his policy by paying a yearly premium.

The premium for super top-up is solely paid by you, the employee. 

How to get super top-up?

You can get super top-up using the Pazcare app or employee dashboard. Before buying, you need to choose a deductible. A deductible is an amount you pay before your insurance coverage kicks in. 

Example for case 1 - Claiming for yourself

Angad has a 5L coverage and then gets a 20L super top up with a 3L deductible. Let’s say he gets hospitalized 1st time and the whole of 5L is used in a cashless claim. He gets hospitalized for 2nd time and the hospital bill is 14L. So here he must pay the 3L deductible and then the remaining 11L is paid by the insurer. The next time he gets hospitalized, he doesn’t have to pay any deductible. There’s 9L left in the super top-up coverage that he can use. 

Hospitalization Bill How it worked
1st hospitalization 5L Covered by existing insurance of 5L coverage
2nd hospitalization 14L Paid 3L deductible and remaining 11L covered by super top-up

If Angad hadn’t been hospitalized the 1st time, he can use his existing health insurance as a deductible. That is, from the 5L cover of the existing insurance, 3L would be deductible, remaining 2L + super top-up 20L is available for claims.

Hospitalization Bill How it worked
1st hospitalization 18L 3L deductible paid by existing insurance. 2L from existing insurance and 9L from super top-up was used to for claim

Example for case 2 - Claiming for your dependents

When Angad’s mom gets hospitalized, the bill comes up to 18L. In this case, the 3L deductible has to be paid by Angad and the insurer will pay 15L. The remaining 5L is for the next hospitalization. 

You can choose the deductible you want to pay. The higher the deductible, the lesser will be your premium.

Hospitalization Bill How it worked
1st hospitalization 18L 3L deductible was paid as there was no existing insurance to cover it. 15L was covered by super top-up.

There are multiple ways to buy super top-up for your family

  1. You can buy a family floater cover which by default covers 2 children and 2 adults. You can add more dependents to this floater as well. You can’t add parents to your family floater policy as the premium will shoot up for the elderly.
  2. You get a single floater cover for both your parents or in-laws. However, you can’t have a mix of 1 parent and 1 in-law in a floater policy.
  3. You can get an individual policy for any of your dependents
Find out what's covered in your super top-up

In short, to buy super top-up from Pazcare, you need to

  • Choose what kind of policy you want 
  • Add dependents if not already added
  • Choose a deductible
  • Read terms and conditions
  • Make the payment

Beneficial features of Super top-up for employees

  1. Remains valid even if you quit your job unlike health insurance given by your company.
  2. Can add spouse, children, in-laws and parents 
  3. Get tax benefit under Section 80D for the premium you pay
  4. 15 days free cancellation of super top-up if you change your mind

Things to know about Super top-up

  • Pre-existing diseases are covered but there is a waiting period of less than 2 years.
  • There is a waiting period of 30 days for any treatment (except accidents) made in the first year of buying super top-up. This is to ensure people don’t buy super-top up right before they figure out they will go for a claim.
  • The premiums are much lesser than buying a policy retail policy, especially for parents.
  • Deductible is mandatory
  • No limit on the number of claims
  • No ICU and room rent limit
  • Home/domiciliary hospitalization of more than 3 days in covered

How to claim super top-up in health insurance?

Cashless claim

You can go to any of the network hospitals of the insurer to get a cashless claim. The insurer will directly settle the bill with the hospital. You need to carry your insurance ID card that is available in the Pazcare app and a government-verified ID card.

Reimbursement claim

You can pay for your treatment first and then get it reimbursed by sending your bills to the TPA/insurer. Pazcare helps you in every step of the claim process.

Remember that any claim can be made only post the waiting period.

Read: Health Insurance Claim Process

Frequently Asked Questions on Super top-up in health insurance

+

What is the meaning of super top-up in health insurance?

Super top-up extends your health insurance coverage. You can get it by paying a premium. It helps you with covering more hospital bills up to a limit specified. You have to pay a deductible to get super top-up activated
+

Should I buy super top-up health insurance?

If you think your current insurance coverage is not enough or if you want to add dependents to your policy, you should buy super top-up. It is easy to increase cover and add dependents with super top-up.
+

What is the difference between top-up and super top-up?

Both are extensions to your existing health cover. However, top-up is valid for only one hospitalization claim and super top-up is valid for all hospitalizations in a year up to the specified limit. You have to pay the deductible for top-up for every claim in a year whereas for super top-up only once in a year
+

How does a super top-up health insurance work?

You choose a deductible and pay the premium for super top-up. When required, you pay the deductible with money or with existing health coverage for it to get triggered to cover your hospitalization expenses.
+

Is a super top-up health insurance plan cheaper?

Yes, compared to retail policy, super top-up is cheaper and has many other benefits like reduced waiting period, ease of adding dependents, etc.
tip icon
tip icon

tip icon
tip icon

Key takeaways

Blog sources

Have questions? We are here to help

No items found.
20,000 HRs have!
Subscribe here.

What you will receive in your inbox?
  • Guides on employee insurance and wellness
  • Surveys and reports
  • Updates on free wellness webinars
  • Features from Champions of HR - A Thought Leadership Initiative