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Here we have got for you two essential terms that are often used in health insurance and general insurance sector. Copayment and deductibles both are the features of health insurance plans. Under this, the payment is done by the insured but the amount and time-frequency are different.

What Is Copayment?

The copayment is a certain percentage of the total amount paid by the insured in respect of any medical services availed by him. whay is copayThe rest of the amount is paid by the insurer.

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Do You Know How Copayment Affects Premium?

Copayments are paid by the beneficiary, technically after having paid mentioned deductibles. The ratio and fluctuations of the copayments and the premiums are mentioned below:

  • If co-payments are high premiums are less.
  • If co-payments are low premiums are high.

The aggregate of copayment and premiums should maintain the limits. It is adjustable concerning the total sum assured. 

Copayments can be taken as flexible facilities provided to the insured by the insurance companies. Copayment comes to the great relief of the insured as well as the insurer. 

By paying copayment the beneficiary of the policy is benefited as the premium amount gets reduced.

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For An Instance

If one takes a health service and the bill to be paid is Rs. 1.5 Lakhs. Then in such a situation according to the percentage of copayment finalized (Copayment percentage is 10%) at the time of buying a policy, the sum is required to be paid by the insured. The insured has to pay Rs.15,000 of the total bill amount and the rest of the amount is to be paid by the insurance company under copayment norms.

What Is Deductible?

The payments done by the insured, within the time duration, before the health insurance benefits are unlocked and begin what is deductibleto cover expense cost of the beneficiary is termed as deductibles and it is an amount that must be paid within the mentioned period, usually a year.

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Facts About Deductibles?

Here are a few of the facts about deductibles that you might not be aware of. Reading it carefully can prove beneficial to you:

  • It is a common feature of health insurance.
  • The deductibles are active until the limit is attained.
  • Deductibles are very clearly mentioned in the terms and conditions of the policy. The top-up plan is an example of this.
  • Higher deductibles lower the premium amount.

For An Instance

Suppose you have got deductible of Rs.2,000 for the entire year and you met an accident in which you got a fracture in your leg. The treatment had cost you Rs.15,000. In this situation, the Rs.2,000 will be paid under deductibles and rest will be payable by the insurance company.

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What Is Similarity In Copayment and Deductibles?

Few of the similarities between copayment and deductibles are mentioned below:

  • Copayment and deductibles are decided at the time of buying a policy and added into the plan.
  • Copayment and deductibles are the features of health insurance.
  • Copayment and deductibles help in limiting the expenses of the policyholder.
  • Copayment and deductibles are an add-on facility provider.

Differences Between Copayment and Deductibles?

There are not many differences between the two. A few are mentioned below:

  • Copayments are in health insurance only and deductibles are both in health insurance and general insurance.
  • The copayments are to be done each time one takes a health medical service. The deductibles are paid once within the fixed time duration.

Conclusion

The medical expenses have surged up at present and these features like the copayments and deductible are very helpful in managing the financial budget of an individual. So, help yourself by buying a health insurance plan and avail the benefits of copayments and deductibles.

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Naval Goel is the founder of PolicyX.com. He is an Associate Member of the Indian Institute of Insurance`, Pune. He has been authorized by IRDA to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.
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