In today’s lifestyle context Health insurance has become a major enabler for handling financial risk which may arise due to bad health condition. With health care inflation at its peak access to better medical facilities and hospitals have become quite expensive. So making a prudent decision while buying a health insurance plan is very relevant looking at your future objectives with respect to your financial plan.To control the cost of health insurance premium , an insurance buyer can opt for a co-pay option.Co-pay was previously more relevant in case of group health plans but now it is available for individual policy holders too.Let understand how much is the co-pay option relevant with respect to your medical costs and health care choices
Let’s understand what copay is, when a policyholder opts for a co-pay option he/she actually agrees to pay a part of the claim whenever it arises. The co-pay option can range in a percentage of 10%-25% The major benefit of a co-pay is option is that if the policyholder opts for a 20% co-pay option in a health insurance plan , he/she might end up paying 20% less premium for the same amount of cover with respect to one who has not applied for it.The insured stands to gain largely when no hospitalization happens during term of the policy.In case when the health insurance claim arises the policyholders need to pay his/her part first and post which the insurer claim settlement process comes in play.
a) Class of service: In case the policy stipulates the policyholders to avail certain standard of service like deluxe room during hospital and if the policyholder opts for a higher standard of service he/she might end up paying a part of the claim.
b) Hospitalization in metro cities, few insurers ask to the policyholder to share the claim amount if he/she opts for getting hospitalized in a metro city . In case it is smaller cities the rule is not applicable.
c) Treatment in certain category hospital, most of the insurers have their list of premium hospitals . In case you opt for hospitalization care in any hospital which falls under the premium list , the policyholder would be asked to pay a part of the claim which it arises.
d) Another type of co-pay option is applicable if the policyholders opts for getting a treatment in a hospital which is not part of the empanelled list of hospitals of the insurer so it is also advised to reach to your insurer before getting admitted to a hospital.
Though co-pay might seems as a relevant feature but the option should be used with complete understanding. In case when the policyholder is young and healthy the co-pay can help you save a lot of money because generally during the early periods of the policy there is a higher chance you not getting hospitalized. On the other hand when you are considering a co-pay option at an older age things can turn awkward. Generally at an older when the medical costs are generally very high , if the policyholder opt for a co-pay option he/she might end up paying huge amount of money from his/her own pocket.
So though co-pay as an option can give you discount in premium but the relevancy of the same changes with the situation so be very cautious while selecting any extra features in a health insurance plan.