What Is Top-Up In Health Insurance And How Does It Work?

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During a medical emergency, a health insurance plan helps cater to your financial needs. However, there are instances when hospital bills surpass the health insurance amount, and you are left with no option but to pay for the extra expenses out of pocket. Fortunately, there's a solution that can help you avoid such situations - a top-up health insurance plan. Such a plan acts as an add-on to your primary health insurance. If you feel that your current sum insured or coverage amount isn't adequate, then opting for a health insurance top-up plan is a wise choice. Keep reading to understand how exactly top-up insurance works.

What is Top-up Health Insurance?

Put simply, top-up health insurance refers to a policy that offers additional medical coverage on top of your existing health insurance. With a top-up insurance plan, you can continue to pay for medical expenses even after exhausting the sum insured on your primary health insurance policy. However, a top-up plan typically includes a mandatory threshold limit or deductible, and coverage is provided only after the insured person has paid this deductible amount. 

Top-up health insurance plans are cost-effective and more affordable compared to basic health insurance. They can also be obtained in addition to the health coverage offered by your employer, offering an extra sum insured to assist you during unexpected medical emergencies if you find that your current medical policy may not be adequate.

How Does Top-up Insurance Work?

A top-up insurance policy is activated only once the sum insured by the standard health policy is depleted. The plan includes a deductible amount chosen by the policyholder when purchasing the policy. You can only claim your top-up insurance plan after paying this deductible amount. You have the option to pay this deductible amount out of pocket or through another health policy. However, it's important to note that you must exceed your deductible limit in a single hospitalisation bill to make a claim. Additionally, you can only claim your top-up insurance plan once in a policy year.

Understanding Top-up Insurance

Let's illustrate the concept of top-up health insurance using the following example:

Imagine you have a health insurance policy with a sum insured of Rs 5,00,000 and you opt to purchase a top-up insurance plan of Rs 10,00,000 with a deductible of Rs 2,00,000. Now, suppose you are hospitalised for an illness, resulting in a hospital bill of Rs 7,00,000. In this scenario, the sum insured of your base policy, Rs 5,00,000, will be exhausted. Additionally, you can claim your top-up plan as the base policy sum insured will cover your deductible amount.

Therefore, if you claim Rs 7,00,000, your base health policy will cover Rs 5,00,000, and the remaining Rs 2,00,000 will be covered by your top-up insurance plan.

Benefits of Top-up Health Insurance

Some of the major benefits of availing top-up insurance plans include:

1. Addressing Medical Inflation

In recent years, we've witnessed a significant surge in medical expenses. A basic health insurance policy might not offer adequate protection for you and your family. In such circumstances, opting for a top-up insurance plan is advisable as it prevents you from depleting your savings after exhausting your base cover. Consequently, a top-up health insurance plan ensures continued access to quality medical care without the worry of additional costs.

2. Increasing Sum Insured

As demonstrated in the example above, acquiring a top-up health insurance plan presents an opportunity to augment the sum insured at minimal expense. This plan preserves your basic insurance coverage and spares you from paying extra premiums for either a new policy with higher coverage or upgrading the existing one.

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3. Enhanced Senior Citizens Protection

Typically, top-up health insurance policies provide senior citizens with improved and more comprehensive protection. Furthermore, several top-up plans lack sub-limits or restrictions on hospital costs, making them ideal for senior citizens who may need frequent medical attention.

4. Accumulating Bonus

In the event of not utilising your top-up insurance plan throughout the policy duration, you may receive a cumulative bonus for each claim-free year.

How to Choose the Best Top-up Health Insurance?

To choose the best top-up health insurance plan for yourself, consider the following points:

  • Avoid purchasing an expensive plan to cover exclusions, such as daily cash allowance and dental cover, as these may already be covered by your regular health insurance policy.
  • Choose higher deductibles for a more affordable plan.
  • Verify if the plan also extends coverage to your family members, including spouses, parents, and children.
  • Ensure to check the waiting period for pre-existing health conditions, named illnesses, critical illness cover, maternity cover, etc.


A top-up health insurance plan undoubtedly helps bridge the gap between actual medical expenses and your current health coverage. Investing in a top-up cover is a beneficial and cost-effective option, especially if you're already covered under an individual cover or a group policy. It's advisable to properly acquaint yourself with the policy’s terms and conditions before purchasing it. 

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Frequently Asked Questions

What is top-up health insurance?

Top-up health insurance is a supplementary policy that offers additional coverage extending beyond the threshold limit of your primary health insurance plan.

When your medical expenses exceed the deductible amount set in your primary health insurance, the top-up policy kicks in to cover the remaining costs.

Top-up health insurance is beneficial for individuals who already have a primary health insurance plan but want to enhance their coverage without paying high premiums.

Key features include higher coverage at lower premiums, flexible deductible options, coverage for specific illnesses, and the option to add family members.

Top-up insurance supplements your existing health insurance by providing additional coverage once the threshold limit is reached, whereas regular health insurance provides coverage up to the sum insured without any deductible requirements.

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