Super top-up plan versus restoration benefit: Which one will suit you more?

How much health insurance is enough? Most people would settle for Rs 3-5 lakh insurance cover pre-Covid. However, the pandemic has changed the mindset. Even existing policyholders want a higher health cover. According to a recent study by Policybazaar.com, as many as 80% of its customers ported to a higher health cover between March and May 2021. If you don’t want to buy a new policy, you can simply purchase a super top-up plan to get additional health cover. Besides, if your policy has a restoration benefit, you may not even need a higher health cover. We explain you all about it:

Super top-up plans

Super top-up plans come with deductibles. You need to exhaust the deductible amount once in a policy year, only then the super top-up will get triggered. A base policy (having sum insured equal to the deductible amount in super top-up) and a super top-up plan makes for the best combination. For example, consider you have a base policy of Rs 5 lakh and a super top-up of Rs 5 lakh cover with Rs 5 lakh deductible. If medical bill amounts to Rs 8 lakh, then Rs 5 lakh will come from the base policy and Rs 3 lakh from the super top-up plan. The next time you get hospitalised, the rest of Rs 2 lakh in super top-up plan will directly take care of the claims amount.

Restoration benefit

Most base policies now come with in-built restoration feature in which the insurer recharges your policy with the same sum insured in the same policy year after you have exhausted it. For example, if you have exhausted the entire sum insured in the first hospitalisation, your policy will still be active. The insurer will take care of the medical bills up to the sum insured on the second hospitalisation.

In the above example if the base policy has a restoration benefit, you don’t need super top-up coverage on the second hospitalisation. Your base policy will again get recharged with Rs 5 lakh after the first settlement is done.

Is super top-up needed if policy has restoration?

Naval Goel, founder, PolicyX, recommends a policy with a restoration benefit vis-a-vis the super top-up plan.

“The biggest advantage with restoration benefit is that it is an inbuilt feature that doesn’t charge extra from the customer and it is an automatic process where customers don’t need to be involved. Wherein super top-up is a rider which person needs to avail separately and pay for it an extra premium,” says Goel.

“This feature is quite an instrumental feature for family health plans where more than one member is a part of the insurance plan and there is no dearth of the sum insured amount for any of the member insured under the policy,” he adds.

When do you need super top-up plans?

If you or a family member in the floater policy is suffering from a severe disease that may lead to astronomical hospital bills, you should have an additional cover via super top-up plans. It will help you get additional cover at a cheaper rate. Besides, restoration benefit has some limitations. Some insurers may not offer it for the hospitalisation due to the same disease or to the same person twice in a family floater policy.

“The restoration benefit can only provide cushion up to the Sum Insured per claim. Hence, buying a Super Top up plan with Guaranteed Continuity Benefit is a smart and economical way to protect yourself and your family from potentially devastating health care bills,” says Shashank Chaphekar, Chief Distribution Officer, ManipalCigna Health Insurance Company.

“Further, most policies do not offer the restoration benefit for the same illness for which you have made a claim in a policy year. Thus, one should look at Super Top Up primarily for conditions and treatments requiring a higher amount of medical expenditures. In case of Super Top Up it allows higher claim size whether the claim is for the same condition or different condition,” he adds.