Making the best of your health insurance with co-pays and deductibles added to base policies seems the need of expensive health care.
When the health insurance covers are very high there are ways by which you can make them work to your benefit. With the rising cost of medical care and sudden hospitalizations - health covers have become very essential. The rising cost of premiums and when some insurance companies do not honor claims people are careful about buying health insurance. According to Anthony Jacob - the chief executive officer, Apollo Munich Health Insurance, existing premiums can be reduced with co-payment and deductible options as they are means of sharing and the cost is controlled due responsible use of health insurance.
"In group health insurance policies, the co-payment clause is increasingly becoming a popular risk control measure by employers as it results in direct savings by reducing the value of claims. When employees are made to share a part of the burden of hospitalization costs, it is widely expected that they will ensure responsible use of the policy benefits and, therefore, control the claims costs," he stated.
Co Payments: Under this plan a fixed amount has to be paid by the insured initially, and then the insurer will settle the claims according to the policy limit. This is used for group health covers commonly as the employer provides cover for the employee and his immediate family. At times employers want co-payments for covering parents as the medical treatment for senior citizens is frequent and expensive.
Deductibles: This clause refers to a specified amount which is not covered by the insurer and it is only after the insured pays this, will the insurance company take over. The deductible can be applied on a pre-claim – where the insurance cover will become effective only after the claim crosses the deductible amount.
A healthy person who has a low risk of being hospitalized can think of a co-payment clause, though it could be a major disadvantage in case there was a large claim. It will be an advantage to a senior citizen as the cost of treatment is usually high and the insurer will have to make part of this.
When the insured is liable to make co-payments they will avoid unnecessary tests and check-ups, as a result the insurance company is more confident of processing and clearing claims. The risk to the insurance company is reduced.
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For those with pre-existing diseases like diabetes or blood pressure where hospitalization is high, a deductible plan is better as this would reduce the premium, according to Prakash Praharaj founder and chief financial planner for Max Secure Financial Planners. A deductible option is good when it is clubbed with a base plan as one can increase the cover at a reasonable cost.
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References:
Hannah Punitha (IRDA Licence Number: 2710062)
Priya Nair, November 2013
Source-Medindia