types of co pay in health insurance

Types of Co-pay

What is co-pay?

Percentage of claimable hospital expense

Paid by the insured

Types of co-pay

Zone related co-pay Network hospital related co-pay Age related co-pay Pre-existing diseases related co-pay

Zone Related Co-pay

Applicable for plans with different premiums for different zones

To paid for treatment in zones with higher expense

E.g. New India applies up to 20% co-pay on their Mediclaim 2007 and Mediclaim 2012 policies.

Network Hospital Related Co-pay

Applicable when treatment is taken under non-network hospital

E.g. Bajaj Allianz applies co-pay of 20% in its Silver Health plan for senior citizens when they get treated in a non-network hospital.

Age Related Co-pay

Applicable when: You buy a policy at specific age Reach a specific age

E.g. L&T’s Medisure Classic applies 10% co-pay for members over 80. Religare applies 20% copay in its policy Care, for members who enter it post age 61.

Pre-existing disease related co-pay

Applicable for claims on pre-existing ailments

E.g. The Star Health Red Carpet policy covers all pre-existing diseases with a co-pay of 50% right from the second year of the policy start and a co-pay of 30% for other specified ailments from the very first year itself!

Co-pay isn’t that bad if you know all the terms and conditions very well...