Is a top-up plan needed with a family health insurance policy?

The top-up health plans come in handy when your health insurance coverage gets exhausted. These plans are beneficial and very affordable.

Health is wealth, and this point cannot be emphasized enough! Taking care of your health as well as your healthcare needs is of utmost importance as only when you are healthy and fit will you be able to deliver to your full potential and succeed in life. Healthcare costs are very high these days and so you need to invest in a good health insurance policy to ensure you always have the means to get yourself treated if there is any threat to your wellness. You should, in fact, protect yourself and all your loved ones by purchasing a family health insurance policy that would benefit everyone. Along with that, consider getting a top-up cover too.

What exactly is a health insurance policy? 

Health insurance is an agreement between a health insurance provider and the policy where the former agrees to cover the health care requirements of the latter in return for a regular payment known as the premium. The coverage is pre-decided, and the insurer is obligated to honor it at the time of the claim, provided the policyholder adheres to the terms and conditions. 

A health insurance plan is very beneficial as it helps you pay off the steep hospital bills. In the absence of health insurance, you have to bear the expenses yourself, which becomes very difficult and unaffordable. 

However, as stated, the coverage in a health plan is limited. For example, if you have a plan for INR 10 lakhs and you have five family members, the amount may not be sufficient. At such times, a top-up health cover comes in handy.

What is a top-up health insurance plan? 

A top-up health insurance plan is a type of health cover that offers additional coverage, over and above the coverage your basic health plan offers. Top-up health insurance is very beneficial and is a smart way in which you can enhance your health insurance benefits. This type of plan can be purchased if you already have basic health coverage, either personal or employer-provided. 

 Understanding how top-up health insurance works

Top-up health insurance is a secondary cover and works in tandem with the primary health insurance plan that you already have. It comes into force once the coverage from the primary policy is exhausted. Let us understand this with an illustration:

Rahul has a family health plan of INR 7 lakhs for himself, his wife, his 6-year-old son and his 57-year-old father. He also has a top-up plan of INR 4 lakhs. In February, Rahul meets with a road accident and is hospitalised. He spends 21 days in the hospital, and his bill amount comes to INR 6 lakhs. He pays it off with his health insurance plan. In June, his father suffered a cardiac arrest and was hospitalised. Thankfully, he recovers, but the bill comes to INR 3 lakhs. Rahul pays INR 1 lakh from his health plan, and the coverage gets exhausted. He pays the remaining sum of INR 2 lakhs with the help of the top-up plan, and all the expenses are taken care of. Apart from a few thousand rupees in deductibles, Rahul doesn’t pay anything out of his own pocket, and this proves to be a very smart financial move.

 Benefits of a top-up health insurance plan:

As you can see, your family health insurance policy may not be sufficient, especially if you have a large family. As the head of the family, it is your duty to ensure all the members are protected and to have access to the best doctors and hospitals whenever there is any requirement. For this, you need to buy a top-up plan along with the family health cover. Here are some of the benefits you get:

  • Extra protection:

The biggest reason for choosing a top-up plan is to enhance overall health coverage. It is easy to boost up the protection and get a much higher sum insured with a top-up policy. Depending on the health coverage alone may not be sufficient.

  • Affordable option:

Top-up health insurance is very affordable. You get a higher coverage amount at a much lower cost. If you get a regular health plan with the same coverage amount, the premium rates would be higher.

  • Fewer clauses and sub-limits:

Health insurance, though advantageous, has several rules and regulations. There are many terms and conditions, sub-limits, restrictions, etc. However, when you get a top-up policy, you find that the rules are less stringent, there are hardly any sub-limits, and the clauses are more flexible.

  • No pre-policy screening:

 You need not opt for a pre-policy health check-up when you apply for a top-up health insurance plan. This is another beneficial reason why you can opt to get a plan. This saves time and effort, and you get the plan quickly.

  • Tax benefits:

You get all the regular health insurance-related tax benefits when you invest in a top-up policy. This includes the income tax benefit available under Section 80 D of the Indian Income Tax Act.


As you can see, the top-up plans are loaded with benefits. They have been specially designed to help people find easy and handy solutions to all their health insurance concerns. Look for a good top-up plan and make the right choice for yourself and your family members.

 Covers available under a top-up policy 

The covers available under a top-up policy are similar to those available in a regular health plan. From hospital bills to home health care, you get every coverage that the standard health plans provide. Some of the most important ones include the following:


  • In-patient care
  • Pre and post-hospital care
  • Daycare procedures
  • Domiciliary care
  • Ambulance expenses
  • Organ donation cover, etc.


As you can see, the covers are quite comprehensive and wholesome. Similarly, the regular exclusions of health insurance also apply to the top-up policies, so you must keep that in mind when you make a claim. Read the policy documents carefully, and you will know exactly what is covered and what is not. 

The final word – should you get a top-up plan? 

Yes, you must most definitely get a top-up plan along with the family health insurance policy. The health care expenses have skyrocketed over the last few years, and you are left with no option but to get the highest possible coverage for yourself and your loved ones. However, doing so with a regular health plan may not be a practical option, and this is precisely why you should make use of the very handy and beneficial top-up policies. Choose the coverage amount carefully and ensure the healthcare needs of your family are never compromised. 

Disclaimer: This article is for illustrative purposes only. For further details, please refer to the policy wordings and prospectus before concluding the sales.

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Christophe Rude

Christophe Rude

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