Deductible in health insurance

The deductible in health insurance is the amount that you have to pay from your pocket at the hospital in case of a medical emergency. This means that if you have a medical emergency and the expenses on it exceed your deductible amount, then the balance amount is paid by your insurer. The biggest advantage of deductible for the insured is that the higher the deductible amount is, the lower the premium is.

Here is an example - suppose your medical expenses or claim amount is Rs 2,00,000 and you have an applicable deductible of Rs 50,000 in your health insurance plan. In this case, you have to first pay Rs 50,000 to the hospital and then you can claim Rs 1,50,000 from the insurer or the company pays the bill by contacting the hospital directly.

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There are mainly two types of deductible in health insurance, compulsory and voluntary. However, individual insurers have introduced some other new deductible plans as well. The deductibles to be covered by health insurance companies are included in the following list:

• Compulsory deductible: These deductible plans are mandatory to be implemented by the insurers. These deductibles may also differ from each other according to different insurance companies. A compulsory deductible is a fixed amount, which has to be paid by the insured every time before making a claim, after which the insurer pays the rest of the bill.
• Voluntary deductible: It is completely different from the compulsory deductible. In this, you can give the deductible as per your wish. A voluntary deductible is considered preferable because here you can pay the deductible if you want and give the amount as per your wish. Also, the higher the amount you pay as deductible, the more your premium is deducted later.
• Comprehensive deductible: This is the only deductible that is applicable on all your insurance policies. The deductible amount keeps adding up till you pay the total amount of the health insurance plan.
• Non-comprehensive deductible: It is applied to certain coverages of your health insurance. This means that you don't have to pay for all medical expenses, but instead only before a claim can be made in certain situations.
• Cumulative deductible: These deductibles are generally applicable only in the family floater plan. In this, the deductible is applied to all the members of the family. If anyone in the family has a medical emergency, then the deductible of the entire family has to be paid before making a claim.

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There are many features related to the deductible that may be considered before deciding whether you should opt for it. The premium amount can be reduced by paying the deductible amount, so you will have to pay less money each time. If the company offers you the feature of voluntary deductible, then you can pay the deductible amount as per your capacity. The deductible is either a fixed amount or a certain percentage of the total coverage amount. Apart from this, the amount of deductible may also vary from company to company.

Including the deductible in health insurance can be a good option because usually, one does not face any problem in incurring minor medical expenses and when the medical expenses go above the limit, the help of the health insurance plan can be taken. A health insurance plan usually protects you against high medical expenses and you can pay for minor health expenses yourself.

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Very few people in India have a health insurance plan. In view of the diseases nowadays, it has become necessary for every person to buy health insurance. Some benefits of deductible in health insurance are mentioned below:

• If your health insurance plan has the option of deductible, it will help in reducing your premium. Your premium is reduced according to the amount you pay as deductible.
• Some insurers may even offer you a special discount if you take the voluntary deductible option. You can also get a special discount while paying the premium by paying the voluntary deductible.
• If the health insurance plan has the feature of deductible, then the insured does not claim for minor medical problems. Doing so increases your chances of getting a no-claim bonus (NCB), increasing the coverage of your health insurance plan or reducing the premium in the form of a no-claim bonus.
• If health insurance has the feature of deductible, then you do not wait for the claim money to arrive as soon as you go to the hospital and pay the deductible out of your pocket. This helps start the treatment of the disease as soon as you go to the hospital and later the insurer contacts the hospital and settles the medical bill.

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As mentioned above, deductible offers many benefits in a health insurance plan. But deductible also has some disadvantages. Below are some of the main disadvantages of deductibles:

• If your insurance company applies a compulsory deductible in the health insurance plan, then, in case of a sudden medical emergency, you will have to pay the deductible amount from your pocket at the hospital before making a claim with the company. If for some unforeseen reasons, you do not have the money, you will not get the claim money from the insurance company until you arrange to pay the deductible.
• If the insurer applies a large amount as deductible, then any medical emergency may hit you hard financially. For example, if you have more than one medical emergency in a short period of time, your monthly income may be affected or your savings may see a substantial decline.
• If you have purchased a family floater, then the company applies the deductible according to the individual. In such a situation, if one person has a medical emergency, then before claiming the medical expenses of only one person, you may have to pay the deductible of all the members of the family.

It is not necessary that the deductible in myUpchar Insurance Plus should be implemented for all. We apply the deductible as per the individual's health and other conditions. Hence, it can be said that the deductible is not applicable for all in myUpchar Insurance Plus. If you are thinking of buying Insurance Plus, then read and understand the inclusions and exclusions in all the documents related to it thoroughly.

(Read more: Benefits of myUpchar Bima Plus Health Insurance)