Co-pay Health Insurance

Co-payment is a unique feature of a health insurance policy, wherein you agree to pay a percentage of the medical expense, and the insurance policy takes care of the rest of the amount. The percentage of co-payment (or co-pay, as it is often called) can vary from 10% to 50% and is clearly specified in the terms and conditions of the health insurance policy.

For instance: Consider a situation where your medical bills amount to INR 50,000 and your insurance policy has a co-payment clause of 20%. You will be required to pay INR 10,000, and the insurance policy will cover the remaining expenses of INR 40,000.

The features of your co-pay policy and the amount that you would need to pay varies from policy to policy:

• Co-pay insurance clauses are common for senior citizens’ health insurance plans or family floater plans because senior citizens often have higher medical expenditures and a higher risk of falling sick

• Sometimes, co-pay clauses are applicable only when patients visit non-network hospitals. This clause is inserted to encourage patients to opt for treatment only from one of the policy’s network hospitals.

• Co-payment insurance policies have a lower premium as compared to the fully compensated insurance policies.

It is important to fully read and understand the terms and conditions of your policy to understand their implications and impact on payment terms

You can purchase an insurance policy without the co-pay clause. However, these policies come with a higher premium