You must have often come across the terms Co-Pay, Deductibles, Co-Insurance in the Health insurance Plans. And most often than not we ignore these and choose a plan. It is better to get an idea as to what these terms mean.

So what are deductibles?

Deductible is the amount that is to be paid by the applicant before the insurance provider starts paying. It basically is the amount exceeding which the claim will be paid by the insurance company. Let us take an e.g. to understand this. Say, deductible amount for your policy is Rs. 40000 and the claim is Rs 50000, in this case scenario the company is liable to pay only Rs. 10000. If the claim is Rs30000, the company is liable to pay anything. For a high premium amount, deductible amount is low and for high deductible amount, premium is higher.

Significance of deductibles in Health Insurance Plans

Deductibles ensure that people don’t make any unnecessary claim or don’t go for hospitalization just because they have Health Insurance Plans. It prevents all such nuisances created by the people. It prevents people from getting a No Claim bonus.One of the benefits you enjoy in the long run comes from high deductibles that ensure a low premium for you to pay.

On the other hand, your insurance is of no use if your treatment amount does not exceed your deductible amount. As if it is less, you are practically not gaining anything. Hence, it is necessary that you go through the scheme related documents carefully before opting for a cover.

Co-pay clause in Health Insurance Plans

There is a fixed amount of money that the applicant has to pay for a specific medical service rest of which will be taken care by the insurance company. This fixed amount is known as co-pay. The nature of the medical service along with the medications helps decide the co-pay amount. Let us assume that your Health Insurance Plans has a co-play clause of 5%. Now, your claim is Rs. 20000. So this means you will have to pay Rs 1000 as co pay amount and the rest Rs 19000 will be covered by the company.

Significance of co-pay clause in Health Insurance Plans

Co-play does a similar job as deductibles. It prevents people from making trivial claims and also ensures reduced burden on Health Insurance Plans providers. Co-pay prevents people who unnecessarily go to hospitals since they have health insurance covered.

One can go for a deductible or co-pay insurance. Several factors like lifestyle, medical condition etc affect the selection. It is advisable to have a thorough idea of the policy and be aware of the details and terms of insurance before blindly signing up for the policy. This way you ensure you don’t get any surprises and shocks that may come your way,

For more details, please refer to policy wordings and prospectus.