Don’t know the difference between a copay vs deductible just yet? We’ve got you covered. A copay and a deductible help determine how much you’ll pay out of pocket these costs can have a major impact on how financially feasible a particular plan is for your budget. We break down terms so you can understand-and with understanding, comes better savings.Ĭhoosing a healthcare plan? In addition to the monthly cost, or premium, it’s critical to understand what else you’ll be responsible for financially. With words like copay, deductible, and out-of-pocket maximum being thrown around, how are you supposed to know what’s what? That’s where our Healthcare Defined series comes in. Sometimes healthcare terms can seem like a whole different language. Once you have met the ceiling of the medical expenses in accordance with your health insurance deductible, you can use your health insurance plan without having to account for deductibles for every claim.Ĭopayment is usually included in specific types of health insurance policies, for instance, Senior Citizen Health Insurance Plans and Critical Illness Insurance Plans.Ī health insurance deductible is usually a part of most health insurance policies to add a layer of protection for the health insurance provider against claims that are of very small amounts.Share on Facebook Facebook Logo Share on Twitter Twitter Logo Share on LinkedIn LinkedIn Logo Copy URL to clipboard Share Icon URL copied to clipboard CriteriaĬopayment is the amount of your health insurance claim that you have to bear from your own pocket.Ī deductible in health insurance is the fixed amount of money that your medical expenses must exceed in order for your health insurance plan to be usable.Ĭopayment can be in the form of a fixed amount or as a percentage of the sum insured under your health insurance policy.ĭeductibles in health insurance are usually in the form of a fixed sum.Ĭopayment has to be paid every time you use your health insurance policy for availing of cashless insurance or filing a reimbursement claim.Ī health insurance deductible is counted for an entire policy year. Here are the major differences between copay and deductible in a health insurance policy. If you are wondering which is better - copay or deductible, then it is important to understand that they are two different concepts and have varying impacts on your health insurance policy. For instance, if the health insurance claim is for ₹50,000, then Aalekh shall copay it to the tune of ₹5,000, and the insurer will pay the remaining amount, that is, ₹45,000. Whilst filing a health insurance claim on the above policy, 10 per cent of the total claim amount shall have to be borne by Aalekh whilst the remaining 90 per cent shall be paid by the insurer. Mr Aalekh has a health insurance policy with a sum insured amounting to ₹1,00,000 and a copay of 10 per cent. Let us understand the concept of copay in health insurance with the help of an example. The copay aspect of your health insurance policy can be either in the form of a fixed sum or a fixed percentage of the sum insured under the plan. The notion of copayment finds its genesis in the sharing of the burden of health insurance payments between the insurer and the insured. As is evident from its name, a copay in health insurance is the amount of your health insurance claim that you have to pay. Copay is another term frequently used in the context of a health insurance policy.
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