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

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 

Remember, 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.

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

What does super top-up do?

Let's understand super top up with 2 examples. 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. He can do this by paying a small yearly premium from his pocket.

Case 2 - Add dependents

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.

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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.

In short,

• Go to the app and select super top up in the home screen
• Choose what kind of policy you want 
• Add dependents if not already added
• Choose a deductible
• Read terms and conditions
• Make the payment

Before buying, you need to choose a deductible. A deductible is an amount you pay before your insurance coverage kicks in. Read on to understand how deductible works.

Deductible example 1

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. This is the 5L given by his company under group health insurance.

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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. 

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If Angad in his first hospitalization itself has an 18L expense then 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. That is 22L is available and 18L will be his claim.

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Deductible example 2

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. Angad's existing group health insurance cannot be used here as his mom is not covered in it.

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

There are multiple super top up options

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

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

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

Frequently Asked Questions on Super top-up in health insurance