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Difference between Co-Payment and Deductible

A lot of people avoid purchasing a Mediclaim policy as the associated terms and conditions are quite complicated to understand. When stepping into the world of health insurance, you need to understand a few terms that may confuse you when making a purchase. In this article, we are mainly concentrating on the cost-sharing component of the policy.

The two types of cost-sharing are –

  1. Co-payment

  2. Deductible

This means you pay a part of your health care expense, while the insurer will pay the other part. Both these terms may sound quite similar, but there is a considerable difference between the two! They differ in when and how much you are supposed to pay, as well as what is left over for your health insurance policy to pay.

What Is Health Insurance?

In today’s world, a health insurance plan is a necessity. It provides you with financial stability in case of severe health issues. In other cases, your insurance provider will offer legal assurance as financial help. However, you must understand your medical plan so that you can avail the benefits.

What Is Co-Payment?

A health insurance component wherein the payment of a percentage of the claim amount that is agreed to be paid by you (the policyholder) is known as Co-payment. This agreement takes place between you and the insurance provider. Under this component, you are liable to pay the percentage you agreed to pay when you make a claim.

You need to read the documents thoroughly while applying for a health insurance plan and understand the said terms and conditions. In case you do not find the co-payment clause in your health insurance plan, check with your provider.

What is Deductible?

Deductibles on health insurance plans are different from other generic deductibles. They can be spread out over the year. Preventive care under health insurance is supposedly provided at no cost to you.

Most cashless health insurance plans cover visits to a Primary Care Physician (PDC) before the deductible is met. Therefore, read up on your coverage thoroughly. You choose a deductible based on your health history.

For instance, you do not require any significant medical assistance and do not anticipate needing it anytime soon; then you can go for a higher deductible.

However, health is unpredictable, and so, this can be a risky decision. Therefore, choose a deductible that is best suitable for you, taking into consideration your medical history as well as the current financial state.

Copay vs Deductible

A co-payment is a pre-defined amount that you have to pay each time you seek health care service. As a matter of fact, you agreed to bear this portion of the claim (in case of any claim made). The insurance provider pays the remaining balance.

For instance, if the approved claim is INR 1 Lakh and you agreed to co-pay 10%, then you have to shell out INR 10000 from your pocket. The insurer will pay the remaining 90%.

A deductible is a fixed amount. You have to pay this amount every year before your health insurance kicks in. The health plan picks up its share of the health care bills after paying the deductible. Higher deductibles lead to lower health insurance premiums and vice versa. It is also known as an out-of-the-pocket expense.

As you can observe, the primary difference between a co-payment and a deductible is that a deductible is an annual process. After you meet with the deductible for the year, you do not have to pay anything until the next year; whereas co-payment is an on-going process. You keep making co-payments every time you seek health care service. Now that you have understood the basic difference between copay vs deductible, learn more about purchasing a health insurance online.

Buy Health Insurance Online

You can avoid hassles by quickly buying health insurance online. Just like everything else, health insurance schemes are also readily available online. Insurance providers now sell medical policies online on their official website. If you cannot decide which plan to choose among the various plans available, you can compare the policies online and select the one that provides affordable premiums and suits your needs the best. If you are wondering how to determine your health insurance premiums, we can help. Use the health insurance calculator available on Finserv MARKETS so that you choose a health plan that is affordable and fulfils your medical necessities. The tool will calculate the premiums based on your preferred coverage and add-ons. 

General FAQs

Q: How do I avail cashless settlements?

A: If you wish to avail a cashless settlement, you must seek medical guidance from network hospitals only.

Q: Is my policy valid PAN India?

A: Health insurance plans at Finserv MARKETS usually cover for treatments across India. However, it is still necessary to make sure of this clause. You must always find out whether the claim settlement in your policy mentions any geographical limitations.

In A Nutshell

Having a basic understanding of co-payments and deductibles is essential before you purchase a health care plan. Seeking affordable premiums should be your next concern. However, if you are looking for affordable health insurance premiums, get in touch with us at Finserv MARKETS.

The health insurance plans available on Finserv MARKETS allows you to benefit from features like bespoke insurance plans, swift claim settlements, reinstatement benefits, extensive coverage, and more. Also read in detail about the health insurance tax benefits you can avail with a Health Insurance plan available on Finserv MARKETS.

Don’t wait! Get health insurance with us today.

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