Deductibles, co-pays, and co-insurance are all terms used to describe the costs of medical care. These phrases can be found in health insurance policies if you read the fine print. Before you pick a health insurance plan, it’s a good idea to understand what these phrases represent.
Deductibles
The health insurance deductible is the amount that a policyholder must pay before the insurance provider will begin to compensate them. To put it another way, the insurance company is only responsible for paying the claim if the amount is greater than the deductible. If your policy’s deductible is Rs 30,000 and the insured’s claim is Rs 40,000, the insurer is only responsible for Rs 10,000. If the claim amount is less than the deductible, however, the insurer is not responsible for any payment.
Deductibles and their Importance in Health Insurance
Deductibles deter people from filing frivolous claims or seeking needless treatment or hospitalization just because they have insurance. High-deductible policies allow you to pay a reduced premium, which saves you money over time. You get a No Claim Bonus if you don’t make unneeded claims for tiny sums. In the long run, the cumulative bonuses assist to enhance the coverage amount. On the other hand, if your treatment expenses do not surpass the stipulated deductible, your insurance coverage is meaningless. So, before you choose a health insurance plan, be sure you understand the terms.
Learn more about Deductibles through a simple example
To further understand how a health insurance deductibleworks, understand the following example: Consider the case when you need to have ₹120,000 worth of surgery. In this case, you will be admitted to the hospital and will make a claim to be reimbursed for your medical expenses. Your insurance coverage, however, has a deductible of ₹20,000. As a result, you will be responsible for paying ₹20,000 out of pocket, with the insurance company covering the remaining ₹1,000,000.
In a different case, you undergo a small hospital operation that costs merely ₹15,000. Because this sum is less than the deductible amount of ₹20,000, you will be responsible for the entire₹15,000 out of your own pocket. You won’t be able to make a claim as the value of the claim is less than the deductible.
Let’s look at why health insurance deductible is essential and how they might help you now that you know what they mean.
In health insurance, there is a provision that allows you to pay a co-pay
A co-pay is a predetermined amount that the insured must pay for a covered medical procedure, with the insurer covering the balance. The amount of the co-pay is determined by the type of therapy and drugs. If your insurance contains a 10% co-pay clause and your claim is for Rs 50,000, you would be required to pay Rs 5,000.
The co-pay clause is intended to deter consumers from filing frivolous or needless claims while simultaneously easing the strain on insurers. People think that if they have MEDICAL INSURANCE, they would be able to receive treatment at the costliest hospitals
