Deductible In Health Insurance

A health insurance deductible is the amount that you must pay out of your pocket before the insurance company starts paying for your medical expenses. The deductible is a fixed amount that the insurance company charges. It can be either a compulsory or a voluntary requirement, depending on the insurer.

On Bajaj Markets, you can find a wide range of health insurance plans at affordable premiums starting from ₹2,104 per year. Simply compare the available options and choose a plan after assessing its terms and conditions.

When you opt for a health insurance plan, you need to pay a deductible before the insurance company starts covering your claim amount. Once your claim surpasses the deductible, the insurance company pays the remaining amount. 

 

Know that higher monthly premiums for insurance plans result in lower deductibles. They aim to reduce the instances of filing minor, unnecessary claims, so that you file claims for genuine healthcare expenses.

 

Here is an example of how deductibles work in health insurance in India: 

• Say your deductible is ₹5,000, and your policy claim amounts to ₹40,000

• In this case, you are liable to pay ₹5,000 from your own pocket

• The insurance company will reimburse the remaining amount of ₹35,000 (₹40,000 - ₹5,000)

Top-up health insurance provides additional coverage on your existing or base health plan. You can activate it only after you have utilised the entire base sum of your plan. Deductibles in top-up health insurance imply that your existing policy covers a portion of your expenses. But your top-up plan activates only after you reach the required threshold. 

 

Here is an example to help you understand it better:

• Say your base plan covers ₹5 Lakhs and your top-up plan also covers ₹5 Lakhs with a deductible of ₹3 Lakhs

• Now the cost of a treatment included in your policy is ₹8 Lakhs

• In this case, you will not have to pay anything because the base plan covers the first ₹5 Lakhs, and the top-up plan covers the remaining amount

There are many factors affecting the deductible amount, such as your age, lifestyle, etc. Here are different types of deductibles in health insurance that you must be aware of:

• Compulsory Deductible

The insurance company mandatorily applies this deductible. You need to pay it every time you file a claim.

• Voluntary Deductible

You can choose to opt for this deductible. This is beneficial if your health requirements are minimal and you may not require financial support from the insurer. Also, selecting a higher deductible lowers your premium.

• Cumulative Deductible

Applicable to family floater plans, this deductible applies to each family member. The insurer covers the remaining claim amount once the total deductible amount is paid collectively.

• Non-Comprehensive Deductible

This deductible applies only to specific covers of your policy, not the entire plan. However, you may need to pay a specific amount before the insurer covers the cost of your treatment.

In health insurance, you and the insurer share the cost of medical care. Your portion includes deductibles as well as co-payments. Refer to the table below to understand how they differ: 

Health Insurance Plans Available at Bajaj Markets