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Health Insurance Deductible

Types of Deductibles in Health Insurance


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Understanding health insurance deductibles and types of deductibles in health insurance are extremely important so that an individual can plan his or her finances. That is, when buying health plans, it is essential to consider the costs of premium and deductibles.

What is Health Insurance Deductible?

A health insurance deductible is the money the insured person is required to pay to the insurer before he or she can start to make claims under medical insurance. This amount is a part of the claim and the rest is borne by the insurer, up to the policy limits and as per the terms and conditions.

Generally, the higher the premium amount, the lower is the amount of deductible the person is required to pay. In the case of lower monthly premium, there is a likelihood that the insured person may have to pay a higher health insurance deductible. Premium is the amount the insured person pays on a regular basis, monthly, quarterly or yearly, to the insurer for the health coverage he or she receives.

How Does Health Insurance Deductible Work?

Let us understand health insurance deductible with an example.

>> Rahul purchased an individual health policy. He raised a claim amount of Rs 40,000. The health insurance deductible set by the insurer is Rs 10,000. In such a case, the amount of claim borne by the insurer would be Rs 40,000 – Rs 10,000 = Rs 30,000. The deductible is the expenses that must be borne by Rahul.

>> In another instance, he makes a claim worth Rs 10,000 and the deductible amount is Rs 15,000. Here, the insurer will not pay anything as it is liable to make payment only when the claim amount is higher than the deductible amount.

Types of Deductibles in Health Insurance

In India, health insurance deductibles are of two types namely:

  • Compulsory deductible: It is mandatory for the insured person and decided by the insurer as a fixed amount that must be paid each time the claim is made.
  • Voluntary deductible: it is an optional feature given to the insured persons to help them minimize their premium costs.

When choosing cashless medical insurance, one should clearly assess the covers that include deductible payments, the covers that do not include deductible payments as well as the exact amount and time intervals for making these payments.

Significance of Health Insurance Deductible

The amount of deductible the insured must pay is mentioned in the policy terms and conditions. In case, it is not clear to understand, he or she must contact the insurer.

Deductibles are applied to safeguard insurers from policyholders who do not make genuine health insurance claims or make claims of small amounts.

It is a disadvantage for the insured person in case the treatment expenses are lesser than the minimum deductible amount specified. Hence, the utmost care and thought should be given when buying a health plan.

A low deductible works best for those who need higher medical coverage especially in chronic ailments, frequent hospitalization, long-term treatment or therapies. However, those having an individual health cover with no dependants can opt for high-deductible. This is because health plans usually have preventive check-up features on cashless basis. Hence, there is no need to worry about deductible payments for blood pressure or cholesterol checks.

Get the best health cover by Religare Health Insurance at affordable premium and deductibles to minimize the cost burden of huge treatment costs.

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