Health insurance is protection that protects us from unaffordable medical care when it is needed most. While the common assumption is that our insurance policy will cover the bills, there are times when we need to cover some of that.
Copay & Deductibles are two such situations that are overlooked when purchasing a policy. After all, it is an informed decision that saves you from paying the hefty sum and getting the best insurance benefits. (Also Read: Would You Like To Get Health Insurance? First Time Buyers Must Follow 5 Important Tips)
What is copayment or copayment?
A co-payment is a cost sharing clause that requires the insured to pay a percentage of the reimbursable costs. This is also one of the most important factors to consider before purchasing health insurance. Understanding the co-payment clause can help you avoid unnecessary financial stress in the event of hospitalization or illness. Another important aspect is that the co-payment is applicable to both cashless and reimbursement requests.
For example, if you are billed for a medical bill of Rs 10,000 and your health insurance has a 10% co-payment clause, then as the insured person you have to pay Rs 1,000 and the insurer pays the rest.
The deductible does not reduce your sum insured; however, it will reduce the amount of entitlement that you will receive.
There are several variations of the copayment that you can find on the market:
● Certain co-payment percentage applicable to each claim
● Certain% of the copayment applies to the dependent claim only
● Lower percentage or no co-payment for employees and relatives and higher percentage of co-payment for parents
● Zonal co-payment
● Copay applicable to claims from non-network hospitals
● Voluntary deductible
● Compulsory co-payment
● Copay for claims preferred outside the specified geographic location
What is a deductible?
A deductible is a clause used by insurance companies as a threshold for policy payments. In simpler terms, a deductible is an amount that the insured person is willing to pay himself. The insurer is therefore not liable for the stated amount of the costs covered.
For example, if the policy has a deductible of Rs 30,000 for an insured amount of Rs 20 lakh, you will have to pay Rs 30,000 and the insurer will pay the rest.
So what’s the difference between a regular policy and a deductible? Quite simply – you pay a significantly lower premium for a policy with a deductible.
For example, a standard premium for a 60 year old woman can cost INR 5,000, while a policy with a deductible can cost INR 2,300. A deductible does not reduce the sum insured. (Insurers determine whether the deductible applies per year, life or event or whether certain deductible limits apply).
Deductible maybe
● Voluntary deductible
● Compulsory deductible
What is the key takeaway or the bottom line?
Your insurance policy may not fully cover your treatments. Therefore, always pay attention to the inclusions and exclusions of your health insurance. With the plethora of health insurances available, don’t forget to compare terms and conditions so your policy is best suited to your needs.
(Expert comments from Nikhil Chopra, Chief Business Officer – Medi Assist Healthcare Services)
source https://dailyhealthynews.ca/zee-money-tip-how-to-save-big-on-your-insurance-premium-personal-finance-news/
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