The health insurance policies that have a copay clause in them are referred to as Copay Health Insurance. These policies have a copay clause in them. According to the copay clause, the policyholder agrees to pay some percentage of the claim by themselves while the rest is covered by the insurance company.
Advantages of a Copay Health Insurance for insurer:
The insurance provider will not have to pay the whole amount of the claim, as some amount is paid by the policyholder itself.
- It prevents the policyholder to claim unnecessary health checkups as they also have to pay some of the amounts from their side.
- It prevents the policyholder to opt for treatment in any expensive hospitals, as the higher the cost of treatment in the hospital, the higher amount they have to pay.
- As the insurance companies have a large capital, it helps them to attenuate their profit and loss statements. the percentage amount which the policyholder has to pay will directly benefit them in their tax benefits.
Advantages of Copay Insurance for Policyholders:
As the policyholders have to pay some of the amounts by themselves, it appears to be an extra expense for them. Due to this, the policyholders will refrain from unnecessary checkups or treatment and follow a healthy lifestyle.
The policyholder under the copay clause has to pay a low premium as compared to that of an insurance policy without a copay. In India, many people cannot afford life insurance. Due to the Copay Health Insurance, many people can do so without bringing a burden on their savings. Care health Insurance with over 15500 healthcare providers and a CSR of 95.2% also provides policies with copay clause.
Disadvantages of a Copay Health Insurance:
If the copay percentage or amount is too high, it will prevent the policyholder from getting life-saving treatment at an expensive hospital. Due to the fear of a high copay percentage, the policyholder will not use the insurance policy, making it completely useless.
The policies and products offered with copay health insurance are very low. Any individual with the knowledge of copay and a stable financial background will refrain from an insurance policy with a copay clause in them.
When and When Not Buy an Insurance with Copay Clause?
So, now that you know about the advantages and disadvantages of a copay health insurance policy, the question arises, whether you should buy it or not?
The important factors that will decide if an individual should opt for Copay Insurance are:
If a person follows a healthy lifestyle, exercises regularly, and with no medical history in their family are less likely to get suffer from a major disease. Such people may go for this policy. The medical history of the individual should also be considered while buying a Copay Health Insurance policy.
On the other hand, it might not be beneficial for an individual with an unhealthy lifestyle and medical history in his family.