Key highlights
Enhances Existing Health Insurance
Provides additional coverage beyond your primary policy’s limit, ensuring you don’t run out of financial protection during high-cost treatments.
Cost-Effective Alternative to Increasing Base Cover
Instead of upgrading to a more expensive primary health insurance plan, a top-up policy offers a higher sum insured at an affordable premium.
Covers Hospitalization & Medical Expenses Beyond Deductible
The policy kicks in only after your medical expenses exceed a predefined deductible limit, ensuring optimal utilization of health insurance benefits.
Flexible Deductible Options
You can choose the deductible amount as per your existing coverage and affordability, allowing customization based on your financial comfort.
Extensive Coverage for Major Illnesses & Surgeries
Offers financial support for critical treatments such as cancer, organ transplants, or prolonged hospitalization due to severe illnesses.
Cashless & Reimbursement Benefits Available
Avail cashless hospitalization at network hospitals or get reimbursed for expenses incurred at non-network hospitals.
Exclusion
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Medical Expenses Below Deductible Limit
If the total expenses do not exceed the deductible amount, the top-up policy will not come into effect.
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Pre-Existing Diseases (Waiting Period Applies)
Pre-existing conditions may have a waiting period of 2-4 years before they are covered.
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Non-Hospitalization Expenses
OPD consultations, diagnostic tests, and day-care treatments that do not require hospitalization may not be covered.
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Maternity & Newborn Expenses
Most top-up plans do not include maternity-related costs unless specifically mentioned.
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Cosmetic & Alternative Treatments
Expenses for cosmetic surgeries, dental procedures, and alternative therapies like Ayurveda or Homeopathy are usually excluded.
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Self-Inflicted Injuries & Substance Abuse
Treatment for injuries due to suicide attempts, drug or alcohol abuse, or reckless behavior is not covered.
Types Of Top Up Mediclaim Policy
Basic Top-Up Plan
Covers expenses beyond a predefined deductible but applies per claim basis, meaning the deductible applies to every hospitalization separately.
Super Top-Up Plan
Offers enhanced coverage by considering cumulative medical expenses within a policy year, making it more beneficial for frequent hospitalizations.
Individual Top-Up Plan
Provides additional coverage for a single person, useful for those who want to enhance personal health coverage beyond the base policy.
Family Floater Top-Up Plan
Extends extra coverage to all family members under one policy, making it a cost-effective option for families.
Employer Group Top-Up Plan
A supplementary plan for employees that works alongside their corporate health insurance, covering costs exceeding employer-provided insurance.
Critical Illness Top-Up Plan
Specifically designed to provide coverage for life-threatening conditions like cancer, stroke, or heart disease when treatment costs exceed regular policy limits.
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Why is it Essential?
Medical inflation is increasing rapidly, and a base health policy may not be sufficient to cover expensive treatments. A top-up ensures you don’t have to dip into savings.
Instead of paying a high premium for a larger base policy, a top-up plan gives extended coverage at a lower cost.
People with pre-existing conditions or seniors who may require frequent medical attention benefit from additional coverage.
Covers unforeseen high medical expenses without financial stress, ensuring uninterrupted medical treatment.
Many employer-provided health plans have limited coverage; a top-up plan fills this gap and provides extra protection.
A Super Top-Up plan considers multiple medical bills over a year, ensuring protection even if hospitalization occurs multiple times.
