Everything to know about Copay health insuranceBy: Answerout
The health insurance industry is the victim of various fraudulent claims. These fraudulent claims have cost the health insurance sector a considerable amount of money. Not only health insurance sector is suffering from unethical activities but also affected innocent customers. To put an end to this copay in health insurance came into the picture. Now mostly all the health insurance policy comes with the clause of Copay health insurance. For someone who is buying health insurance for the first time, it is important to understand everything about Copay. Copay refers to the arrangement between the insurer and insured where a certain amount of the claim is to be borne say 10 percent by the insured and the rest is paid by the insurer. Thus the claim under Copay health insurance is sharing basis as per the percentage basis. The health insurance policy of the individual will include the clause copay along with the percentage. Thus one must read the insurance policy to be aware of what amount of medical expenses will have to be borne by them. The Copay clause was needed for an hour for insurance companies as it helps them a good portion of their expenses. Besides this, there are various reasons why the Copay clause was included in the health insurance policy. These are mentioned below:
- As the claim is to be paid on sharing basis, this discourages the policyholders to make claims over common diseases such as cold, cough, etc. In absence of this clause, many people used this claim and the insurance company was technically responsible to pay for it.
- The inclusion of the Copay clause brings a sense of ownership among the insured as they now know they are also responsible for their medical expenses.
- This also discourages people from getting the treatment from expensive hospitals unnecessary. As some part of the expensive medical bills are to be borne by the individual as well.
- Copay percentage: It is important to know about the copay percentage as this will clarify the cost will the policyholder is required to pay.
- Premiums: As under Copay health insurance the expenses are to be borne by both parties thus one can expect a lower premium than the general health insurance. It is thereby important that one compares their health insurance with the Copay clause with general insurance and choose the policy only when the premium charged by the former is less.
- The majority of the claim of the medical bill under Copay health insurance is paid by the insurance company and only some percentage say 10 percent is to be borne by the insured.
- The scope of copay medical health insurance includes almost everything from doctor’s fees, hospitalization expenses, and lab tests to medicines.
- The Copay health insurance with a higher premium monthly has a low Copay percentage i.e. the insurer has to pay less amount of medical expenses to claim.
- This type of insurance plan applies to senior citizens.
- The main aim of the inclusion of this Copay clause is to ensure that there are no fraudulent and unnecessary claims.