Co-payment rule is applicable as many times as the policyholder makes a claim. The co-payment percentage may also vary in different health insurance policies. Therefore, while taking a health insurance policy, one should know about it very well.
New Delhi. People often complain that health insurance companies do not pay the claims of customers in full. At the time of claim settlement, she sits down by opening the box of terms and conditions and tries that she has to pay the least amount. But, the companies argue that at the time of giving the policy, all the terms and conditions are mentioned in the policy documents. In their respective places, both are correct. The reality is that most people buy a policy only after looking at the premium and coverage. They neither try to know the rules nor bother to understand the terms.
In most of the health insurance policies, there is one such condition of co-payment or co-payment. Most policyholders are not aware of co-payment. They come to know about it only when they apply for the claim and the company pays them less citing co-payment. The co-payment affects the policy premium to claim settlement. Therefore, while taking a health insurance policy, one should know about it very well.
What is co-payment?
Co-payment or co-payment is that part of the insurance claim, which has to be paid by the policyholder himself. The co-payment percentage may also vary in different health insurance policies. Usually it ranges from 10 to 30 percent. Let’s assume that the co-pay of the insurance policy you have taken is 30 percent. Now if you claim Rs 1,00,000, the insurance company will give you only Rs 70,000. You will have to pay the remaining Rs 30,000 from your own pocket.
The special thing is that the number of times the policyholder makes a claim, the rule of co-payment is applicable as many times. In this type of co-payment health insurance is an agreement between the policyholder and the insurer, in which the policyholder pays some percentage of his medical bills on his own and the rest is paid by the insurance company.
Is this a mandatory part of the policy?
Absolutely no, it is not necessary that every health insurance policy has the option of co-payment. That is, you can get 100% of your claim. Many companies also offer health policies in which they are liable to pay 100% of the claim.
Effect
of Co-payment Co-payment has a great impact on the health insurance policy. The premium of the insurance policy is determined by co-payment. The policy in which the co-payment portion is higher, the premium is lower. In this case, the insured has to pay more money out of his pocket on the treatment expenses. On the other hand, if the co-payment is less in a policy, then its premium is high. But, the advantage of low co-payment is that the policyholder has to pay less out of pocket for the treatment expenses.
