Top-up Health Insurance
What is Top-up Health Insurance?
As medical costs skyrocket, a basic health plan of ₹3 Lakhs or ₹5 Lakhs may not be enough for major
surgeries or critical illnesses. Top-up Health Insurance is a smart, cost-effective way to increase your
total medical cover without buying another expensive base policy. It acts as an "extra layer" of
protection that triggers once your medical bills cross a pre-defined threshold called the 'Deductible.'
Think of it as a safety net for catastrophic medical bills. Whether you have a corporate health plan or
a private individual policy, DigiAssure's Top-up and Super Top-up plans provide you with massive
coverage (up to ₹1 Crore) for a fraction of the cost of a standard plan. It ensures that when a major
medical crisis hits, your financial stability remains intact, allowing you to access the best healthcare
without worrying about exhausting your limits.
The Smart Way to Upgrade Protection
1. Massive Cover, Low Premium
Since the policy only pays for claims above the deductible, the premium is up to 70% cheaper than a standard health policy of the same sum insured.
2. Enhances Corporate Plans
Perfect for employees whose company health cover is small. Use your corporate plan for small claims and let the Top-up handle the big emergencies.
3. Super Top-up Advantage
Unlike a regular Top-up which considers a single claim, a 'Super Top-up' tracks the aggregate of all hospitalizations in a year to cross the deductible.
4. Comprehensive Security
Once the deductible is crossed, the policy provides all standard benefits—ICU, surgeries, ambulance, and pre/post-hospitalization costs.
Key Features of Our Plans
Deductible Flexibility
Choose a deductible (₹2L, ₹3L, ₹5L, etc.) that matches your existing base policy or your ability to pay out-of-pocket.
Individual & Floater
Available as both individual plans or as a family floater to protect your entire household under one high-limit policy.
Restoration Benefit
Available in Super Top-up plans, ensuring that if you exhaust your limit, it refills for subsequent unrelated illnesses.
No Medicals (Up to 55)
Usually, no medical screening is required for applicants up to the age of 55, making the buying process fast and easy.
Tax Benefits
Premiums are eligible for tax deductions under Section 80D, just like your primary health insurance policy.
Global Treatment
Option to extend your coverage for planned treatments at top international medical facilities across the world.
Top-up vs Super Top-up
Which additional layer of protection is right for you?
| Feature | Standard Top-up Plan | Super Top-up Plan |
|---|---|---|
| Claim Calculation | Single Hospitalization Basis | Aggregate Annual Basis |
| Deductible Trigger | Each claim must cross deductible | Sum of all claims crosses deductible |
| Multiple Hospitalizations | Higher cost (each needs deductible) | Highly Economical |
| Ideal For | Major one-time surgeries | Chronic illnesses / Multiple incidents |
| Premium | Very Low | Slightly higher than Top-up |
| Flexibility | Moderate | Maximum |
Coverage Breakdown
Understand the scope of your enhanced health safety net.
What we Cover
Benefits after deductible is crossed:
- Inpatient Care (Room, ICU, Surgery)
- Specialist & Anesthetist fees
- Diagnostic tests & Medicine bills
- Pre-hospitalization (up to 60 days)
- Post-hospitalization (up to 180 days)
- All Daycare procedures
What we Don't Cover
Standard policy exclusions:
- Claims below the deductible amount
- Cosmetic or Obesity treatments
- Injuries due to substance abuse
- Self-inflicted injuries / Suicide
- Unproven or experimental medicine
- Maternity (unless specifically added)
Valuable Add-Ons
Optional covers to customize your high-limit policy.
Consumables Cover
Covers the cost of medical items like PPE kits, gloves, and nebulizers which can add up to 10% of a major surgery bill but are excluded in base plans.
Critical Illness Rider
Provides a lump sum payout upon diagnosis of life-threatening illnesses, acting as an extra financial buffer over and above the medical bill settlement.
Personal Accident Cover
Adds financial security against accidental death or permanent disability, providing a comprehensive protection package for high-risk events.
Hospital Daily Cash
Provides a fixed daily allowance during hospitalization to cover miscellaneous expenses like food and transport for family members.
Factors Affecting Your Premium
Understand how we price your enhanced safety net.
1. Chosen Deductible
The higher the deductible you choose (the amount you pay first), the lower your premium will be. Doubling the deductible can halve the cost.
2. Age of Eldest Member
Similar to standard health plans, premiums increase as the age of the eldest insured member increases due to higher medical risks.
3. Total Sum Insured
Choosing a higher total limit (e.g., ₹50 Lakhs vs ₹20 Lakhs) will increase the premium, though the incremental cost is very low.
4. Policy Type (Top-up vs Super)
Super Top-up plans, which track aggregate claims, have a slightly higher premium than regular Top-up plans due to their superior coverage.
5. Family Size
Adding more members to a family floater Top-up plan will increase the total premium payout for the policy.
Documents Required
Simplified documentation for enhanced protection.
Identity Proof (of the Proposer)
- Aadhar Card
- PAN Card
- Passport / Voter ID
- Driving License
Existing Policy (Recommended)
- Current Individual Health Policy Schedule
- Corporate Health Insurance Card
- Details of the deductible amount you wish to match
Photographs
- 2 Recent passport size photos of all members
- Clear background and frontal face view
Medical Records
- Reports from recent medical check-ups (if age > 55)
- Details of existing chronic conditions
- Past surgery records (if any)
Top-up Claim Process
How to coordinate between your base policy and your Top-up plan.
Hospitalization
Seek treatment. If you expect the bill to cross your deductible, notify both the base insurer and DigiAssure.
Base Policy Settlement
Use your base health policy (private or corporate) to settle the bill up to your limit/deductible.
Obtain Settlement Letter
Collect the 'Claim Settlement Summary' and certified true copies of all bills from your primary insurer.
Top-up Intimation
Submit the digital intimation form to DigiAssure along with the estimated amount exceeding the deductible.
Document Submission
Upload the base insurer's settlement letter and all medical documents via our digital portal.
Verification
Our team verifies that the medical expenses are admissible and that the deductible has been legally met.
Balance Settlement
The remaining bill amount (above the deductible) is settled directly with the hospital or reimbursed to you.
Continuous Support
Our claim advocacy team coordinates with both insurers to ensure you don't face any paperwork hurdles.
Frequently Asked Questions
Common queries about Top-up and Super Top-up plans answered.
Do I need a base policy to buy a Top-up plan?
Technically, no. You can buy a Top-up plan without a base policy. However, you will have to pay the deductible amount out of your own pocket for any claim. It is highly recommended to have a base policy (individual or corporate) to cover the deductible.
What is a 'Deductible'?
The deductible is the initial amount of a medical bill that you or your base insurance must pay. The Top-up policy only pays for expenses that exceed this amount. For example, if your deductible is ₹3L and your bill is ₹5L, the Top-up pays ₹2L.
Is 'Super Top-up' better than a regular 'Top-up'?
Generally, yes. A regular Top-up considers only a single hospitalization bill to cross the deductible. A Super Top-up considers the sum of all hospitalizations in a year. This makes Super Top-up much better for chronic illnesses or multiple small emergencies.
Can I buy a Top-up from a different company than my base policy?
Yes, absolutely. You can have a base policy with Company A and a Top-up plan with DigiAssure. During a claim, you just need to provide the settlement letter from Company A to us.
Does it cover pre-existing diseases?
Yes, Top-up plans cover pre-existing diseases after a waiting period (usually 2-4 years). If you are porting an existing policy, your waiting period credits can often be transferred to the new Top-up plan.
Can I use this for my parents?
Yes, Top-up plans are an excellent way to provide high coverage for elderly parents at an affordable cost, especially if they already have a small base policy or a senior citizen health plan.