Terms such as copay, coinsurance, and deductible, can be confusing for someone with limited knowledge to understand.
In the following article, we will explain the meaning of copay, coinsurance, and deductible. We will see what they mean together and how they are different.
Copay or Co-payment refers to a fixed amount of money you need to pay for certain types of treatment when the rest balance amount will be paid to the insurer. This can be a pre-decided amount or a percentage of the total cost of treatment depending on the policy you choose.
If you have a copay health insurance of 10% then you will have to pay Rs.1500, while the company will bear the expense of Rs.13500.
Deductibles are a fixed amount of money that you have to pay before your policy kicks in to take charge of your medical treatment. This is a certain amount that you have to pay towards your medical bills before your policy kicks into action.
Coinsurance refers to the percentage of a treatment cost you’ll have to pay once you’ve paid the deductibles. This is usually a fixed percentage and is like copayment.
Understanding Copay, Coinsurance, and Deductibles Using an Example
Let’s suppose the bill is Rs.15,000 and your policy says the deductible is Rs.2000. So, you’ll have to pay just Rs.2000 while the balance of Rs.13,000 will be borne by the insurer company.
Let’s suppose the bill is Rs.15,000 and your policy says the deductible is Rs.2000. So, you’ll have to pay just Rs.2000 while the balance of Rs.13,000 will be borne by your insurance company.
Suppose the deductible is Rs.5000. That means you’ll have to pay Rs.5000 towards your treatment before the policy can come into effect.
Coinsurance comes into effect once deductibles have been paid. Let us say you have a bill of Rs.10,000 and you have a deductible of Rs.5000. Then coinsurance will be levied on the sum of Rs.5000.
Copay is the fixed amount that you have to pay towards your treatment. It can be a fixed amount per the nature of the treatment or a fixed percentage.
The deductible is the amount that you need to pay as a share towards your medical bill upon which your policy comes into effect.
Copay is the fixed amount that you have to pay for your treatment. It can be a fixed amount per the nature of the treatment or a fixed percentage.
A deductible is the fixed amount that you have to pay as a share of your medical bill upon which your policy comes into effect.
Coinsurance refers to the percentage of treatment cost you’ll have to pay once you’ve paid the deductibles. This is usually a fixed percentage and is similar to co-payment.
The deductible is the amount that you need to pay as a share towards your medical bill upon which your policy comes into effect.
While deductibles and coinsurance are clauses that are implemented by insurance providers simultaneously, some of them also choose to put together Copay and Deductible. If your insurance does the same, this is what it means for you:
Even if your premium amount is reduced in a cost-sharing policy, your liability towards the share you have to pay on claim will increase and so you’ll always need to have readily available money to cover the cost. It is better to opt for a policy that is free of cost-sharing clauses and with a plethora of premiums offered in India, it is possible to find one that is good and doesn’t involve cost-sharing terms.
Important Note: Be sure to check all the terms and conditions before choosing a policy that best fits you.