Skip to main content

Co pay in your Health Insurance Plan

Buy Health Insurance Plan Online
 
 
 
Health Insurance article in Advisorkhoj - Should you opt for co pay in your health insurance plan
 

Health insurance is a critical financial need in this age of ever increasing healthcare expenses. However, as cost of healthcare and the accessibility to better and more expensive hospital facilities in India is increasing, the cost of health insurance is also increasing. To reduce the amount of health insurance or Mediclaim premium, insurance buyers can opt for the co-pay option. Many health insurance companies have now introduced the co-pay option in their Mediclaim policies. Co-pay option is becoming increasingly common in group health insurance plan. Many individual Mediclaim plans also now have co-pay options. We will discuss about co-payment impacts your Mediclaim costs and your healthcare choices.

What is co-pay?

In a co-pay option the insured agrees to pay a percentage of the health insurance claim. The percentage of co-pay is in the range of 10 – 25%. The insured must first pay his or her share of the claim and then the insurance company settles the balance amount up to the limit specified in the sum insured of the Mediclaim policy. For example, if you have 20% co-pay option in your Mediclaim policy and your claim is Rs 1 lac, then you have to pay Rs 20,000 and the insurance company will pay the balance Rs 80,000 provided your sum insured is Rs 1 lac or more. Let us take another example. If your sum insured is Rs 1 lac with 20% co-pay option and your claim is Rs 1.5 lac, then you have to pay Rs 70,000 while the insurance company will pay Rs 80,000.

What is the benefit of co-pay?

If you opt for co-pay, then your Mediclaim premium will be lower. For example, if you opt for 20% co-pay, then your Mediclaim premium can be lower by up to 20%. So the insured stands to gain by opting for co-pay if there is no hospitalization in the policy term. However, if there is a hospitalization then the insured has to pay his or her co-pay amount, thereby incurring higher expenses.

Different co-payment policies

Different insurers have different co-payment policies. We will discuss some of the policies below:-

  • Class of service:

    Some insurers charge higher co-pay if the insured avails a higher class of service. For example, if the insured opts for a deluxe suite, then he or she may have to pay higher co-pay charges. The insured must bear this mind when selecting the class of service, if his or her Mediclaim policy stipulates such a clause.

  • Hospitalization in metro cities:

    Hospitalization costs in metropolitan cities are much higher. Some Mediclaim policies do not require any co-pay if the hospitalization is in a non-metro city. But if the insured undergoes hospitalization in a metro city, then they may have to co-pay a portion of the claim.

  • Treatment in a non-network hospital:

    Some Mediclaim policies may require co-pay if the insured undergoes treatment in a non network hospital. The insured should confirm this, while selecting a hospital. The network of empanelled hospitals can change any time, even during the policy term of the insured. Therefore, it is advisable to call the health insurance company before hospitalization to confirm whether a particular hospital is empanelled with the insurer.

  • Treatment in a certain category of hospital:

    Some insurance companies label certain hospitals as expensive. Treatment in such hospitals may require higher co-payment depending on the clause in the Mediclaim policy. The insured should confirm this by calling the health insurance company before making a decision.

  • Pre-existing medical conditions:

    In most Mediclaim policies pre-existing medical conditions are excluded from the cover for the first 3 years or so. Thereafter the insured can claim for treatment of pre-existing conditions, but such treatments may require co-payment from the insured.

Should you opt for co-pay?

  • If you are covered under your company's group health insurance plan, you may not have an option. You will be bound by the co-payment contract between your company and the health insurer. Some companies do not require co-pay if the employee is hospitalized, but require co-pay if their parents are hospitalized. In such cases, depending on specific health related risks of your parents, you may want to buy separate Mediclaim for your parents or even a family floater policy. You have to see the trade off between the co-payment for specific health issues and the cost of premium of a separate plan, to make an informed decision

  • If you are young and healthy with no medical conditions, you should opt for co-pay because you will save on the cost of Mediclaim premiums. Over a period of time, this cost saving can be quite substantial.

  • If you are a senior citizen with known medical conditions, you should not opt for co-pay. The cost of hospitalization for a serious illness can be quite huge, and the co-payment amount will also be quite substantial.

Conclusion

Co-payment can help you reduce your health insurance costs. You should weigh the pros and cons when buying a Mediclaim policy with co-payment clause. There is standard format for co-payment clause in your Mediclaim policy document. Therefore, you should read the policy document very carefully to understand the different provisions of the co-payment clause.

(Insurance is the subject matter of the solicitation. For more details on the risk factors, term and conditions please read sales brochure of the respective companies carefully before concluding the sale and/or contact an IRDA Licensed Insurance Advisor/ Insurance Broker)

-----------------------------------------------
Invest Rs 1,50,000 and Save Tax under Section 80C. Get Great Returns by Investing in Best Performing ELSS Mutual Funds

Top 10 Tax Saving Mutual Funds to invest in India for 2016

Best 10 ELSS Mutual Funds in india for 2016

1. BNP Paribas Long Term Equity Fund

2. Axis Tax Saver Fund

3. Franklin India TaxShield

4. ICICI Prudential Long Term Equity Fund

5. IDFC Tax Advantage (ELSS) Fund

6. Birla Sun Life Tax Relief 96

7. DSP BlackRock Tax Saver Fund

8. Reliance Tax Saver (ELSS) Fund

9. Religare Tax Plan

10. Birla Sun Life Tax Plan

Invest in Best Performing 2016 Tax Saver Mutual Funds Online

Invest Online

Download Application Forms

For further information contact Prajna Capital on 94 8300 8300 by leaving a missed call

---------------------------------------------

Leave your comment with mail ID and we will answer them

OR

You can write to us at

PrajnaCapital [at] Gmail [dot] Com

OR

Leave a missed Call on 94 8300 8300

-----------------------------------------------

Popular posts from this blog

Post Office Deposits Interest Rates

Best SIP Funds to Invest Online   SIPs are Best Investments when Stock Market is high volatile. Invest in Best Mutual Fund SIPs and get good returns over a period of time. Know Top SIP Funds to Invest Save Tax Get Rich For further information on Top SIP Mutual Funds contact  Save Tax Get Rich on 94 8300 8300 OR You can write to us at Invest [at] SaveTaxGetRich [dot] Com

LIC Leave Encashment Plan

LIC Leave Encashment Plan       Best Tax Saver Mutual Funds or ELSS Mutual Funds for 2015 1. ICICI Prudential Tax Plan 2. Reliance Tax Saver (ELSS) Fund 3. HDFC TaxSaver 4. DSP BlackRock Tax Saver Fund 5. Religare Tax Plan 6. Franklin India TaxShield 7. Canara Robeco Equity Tax Saver 8. IDFC Tax Advantage (ELSS) Fund 9. Axis Tax Saver Fund 10. BNP Paribas Long Term Equity Fund You can invest Rs 1,50,000 and Save Tax under Section 80C by investing in Mutual Funds Invest in Tax Saver Mutual Funds Online - Invest Online Download Application Forms For further information contact Prajna Capital on 94 8300 8300 by leaving a missed call --------------------------------------------- Leave your comment with mail ID and we will answer them OR You can write to us at PrajnaCapital [at] Gmail [dot] Com OR Leave a missed Call on 94 8300 8300 --------------------------------------------- Invest Mutual Funds Online Invest Any Mutual Fund Online Download Mutual Fund Application Forms fro

Power of Compounding in Investments

Power of Compounding in Investments Invest Rs 1,50,000 and Save Tax up to Rs 46,350 under Section 80C. Get Great Returns by Investing in Best Performing ELSS Funds. Save Tax Get Rich Top 10 Tax Saver Mutual Funds for 2017 - 2018 Best 10 ELSS Mutual Funds to Invest in India for 2017 1. DSP BlackRock Tax Saver Fund 2. Tata India Tax Savings Fund  3. Birla Sun Life Tax Relief 96 4. ICICI Prudential Long Term Equity Fund 5. Invesco India Tax Plan 6. Franklin India TaxShield  7. Reliance Tax Saver (ELSS) Fund 8. BNP Paribas Long Term Equity Fund 9. Axis Tax Saver Fund 10. Sundaram Diversified Equity Fund Invest in Best Performing 2017 Tax Saver Mutual Funds Online Invest Best Tax Saver Mutual Funds Online Download Top Tax Saver Mutual Funds  Application Forms For further information contact  SaveTaxGetRich on 94 8300 8300 OR You can write to us at Invest [at] SaveTaxGetRich [dot] Com OR Call us on 94 8300 8300

MF SIP Top Up Online

Mutual Fund SIP Top Up Online As your monthly income grows, so should your savings. With this facility, you can increase your existing monthly SIP contributions. This can be done on a half-yearly and yearly basis. And you can top up with a minimum of Rs.500 per installment or multiples of Rs.500 as per your convenience.

Kotak Banking Exchange Traded Fund (ETF)

Download Tax Saving Mutual Fund Application Forms Invest In Tax Saving Mutual Funds Online Buy Gold Mutual Funds Leave a missed Call on 94 8300 8300 Kotak Banking Exchange Traded Fund (ETF) Kotak Mahindra Mutual Fund has launched Kotak Banking Exchange Traded Fund ( ETF ). The fund aims to provide returns before expenses that closely correspond to the total returns of stocks belonging to the CNX Bank Index , subject to tracking error. For further information contact Prajna Capital on 94 8300 8300 by leaving a missed call Leave a missed Call on 94 8300 8300 Leave your comment with mail ID and we will answer them OR You can write back to us at PrajnaCapital [at] Gmail [dot] Com --------------------------------------------- Invest Mutual Funds Online Invest Any Mutual Fund Online Download Mutual Fund Application Forms from all AMCs Download Mutual Any Fund Application Forms --------------------------------------------- Best Performing Mutual Funds Largecap
Related Posts Plugin for WordPress, Blogger...
Invest in Tax Saving Mutual Funds Download Any Applications
Transact Mutual Funds Online Invest Online
Buy Gold Mutual Funds Invest Now