Best Health Insurance Plans with No Copayment in India

Introduction

Whether we talk about -

• The Chunky Dunky Nike x Ben & Jerry
• Nike x Billie Eilish
• Our Place x Selena Gomez
• Nike x Serena Williams
• Gucci x Harry Styles

-collaborations have always been the cherry on the top - profit for the celebrity, profit for the brand - and well “cha-ching” - green mint everywhere! Such is the story of collaboration.

But, what happens if we think about collaboration in financial sectors, or more specifically, in the health insurance industry? Are they equally successful? Of course, we are talking about copayment of course - the collaboration between an insurer and an insured during claim settlement towards a health insurance plan.

So are copayments in health insurance a good perk, what are its usage, what are the best plans that come with no copayment features, and what might be its impact on health insurance premiums? It’s time to find out!

What is No-Copayment in Health Insurance?

Copayment in health insurance policies is a pre-decided ratio between the insurer and the insured individual that is reflective of the share of payment that each of the two parties will pay during the claim settlement process.

Here’s an example of how this works:

Navin buys a health insurance plan from one of the best health insurers in the nation. His health insurance policy document came with a copayment clause that asked 20% copay of him. Here’s a look at how his hospital bills were paid off during his 1st hospitalisation that was covered under his policy -

• Coverage = INR 20 Lakhs
• Hospital Bill = INR 4 Lakhs
• Decided Copayment = 20%
• Payment by the Health Insurer = INR 3,20,000
• Payment by the Insured Individual = INR 80,000

One look at this and you start wondering immediately as to why would any individual ever opt for this option, after all, doesn’t one avail of a health insurance plan to avoid spending from one’s savings during health crisis moments?

We say “Touché”!

However, the problem is - desperate times call for desperate measures. Imagine a situation where a policyholder is either -

1. A senior citizen with chances of multiple health complications who is being denied policies from even the best health insurance providers during to higher risks of payout over multiple hospitalisations, or
2. An individual with pre-existing diseases who is being turned down for policies by the insurers because of the high chances of lengthy and complicated treatments, procedures, and hospitalisations that will have to be covered by a plan.

Under such circumstances, copayment is the sole and only way out to get a plan. However, if these two aren’t what you relate with, then, no questions asked, no-copayment health insurance plans are your financial and medical BFF.

What are the Pros and Cons of No-Copayment in Health Insurance?

When it comes to no-copayment health insurance policies offered by the best insurers, the benefits are enormous, and the downsides are almost negligible.

A. Pros of No-Copayment in Health Insurance

(i) No expenses out of pocket - When there is no copayment involved, policyholders do not need to worry about spending out of their pocket during medical emergencies despite having coverage that should act as a financial shield to protect his/her savings. The health insurer will be covering all of the expenses involved in the hospitalisation (unless you have exceeded the room rent restrictions in which case you will be paying off the bill on a pro-rata basis).

(ii) Convenient access to quality healthcare - When there is a copayment involved, policyholders, despite having health insurance policy coverage, are in two minds when availing of a high-end treatment that is medically required. This is because they will have to dig into their pockets to pay off their hospital invoice, partially.

With copayments no longer a hurdle, and insurers to handle the expenses completely, policyholders need not worry about availing quality healthcare services to ensure guaranteed treatment and efficient cure at the earliest.

(iii) Easy claim settlement procedure - When copayments are involved in a health insurance policy, the claim settlement process becomes a complicated procedure, with both the policyholder and the insurer involved. The calculation of the share to be paid by each party, the payments to be in sync and paid towards the invoice, etc. - all complicate the process immensely.

When you avail of any of the best health insurance plans available in the market that comes with no copayment clauses, you ensure the path to a swift, uncomplicated, and convenient claim settlement procedure.

(iv) Uncomplicated health insurance plan comparison - When it comes to availing of health insurance plans, potential policyholders need to understand that this is a huge financial responsibility that is in for the long run.

Hence, such decisions require one to bank on trustworthy free health insurance policy comparison tools and unbiased health insurance experts so that they can take an informed decision when choosing a policy.

While determining the plan that would best suit one’s medical and financial requirements, multiple factors are taken into consideration already (for example - room rent restrictions, disease-wise sub-limits, pre and post-hospitalisation expense coverage, network hospital, etc.). Adding the copayment clause too into this mix would only complicate matters further. So, it’s best to choose a no-copayment health insurance plan and take this parameter out of the list completely.

(v) Smooth preventive care coverage - With the burden of copayment on one’s head, policyholders might want to avoid screening and preventive care procedures considering the financial share of the consequences that he/she will have to take up. On the other hand, with a no-copayment health insurance plan, policyholders can conveniently avail of preventive care procedures that are crucial to the early diagnosis and treatment of any ailments.

(vi) Effortless coverage for chronic ailments - Chronic ailments call for the need for repeated hospitalisations over lengthy treatment procedures. If you have opted for a no-copayment health insurance policy, then you need not worry about contributing towards repeated copayments and your healthy insurance provider will shoulder all the financial responsibilities towards your hospital invoices.

B. Cons of No-Copayment in Health Insurance

(i) Higher premium - With any health insurance provider and plan there is always an option to go for copayment. The perk that such optional copayments offer is a reduced premium for your health insurance plan. With a no-copayment policy, you will be paying the normal premium amount.

REMEMBER: While a copayment-imbibed plan might offer you a mitigated premium, the long-term financial implications of this when you keep paying 10%-20% of the hospital bills every time you are hospitalised, are immense.

(ii) Chances of low/no coverage if you are a senior citizen/one with pre-existing ailments - If you are focused on availing of a no-copayment health insurance plan only, and are a senior citizen or one with a pre-existing medical condition, then you are going to find yourself at a dead-end. When it comes to high-risk payout cases, health insurers are reluctant to offer plans at all, or even if they do offer coverage, the premiums are too high or the coverage too low. Under such circumstances, the only option that can water down the situation to get individuals to have their hands on a mediclaim policy is accepting the copayment clause. If you are too stringent with a no-copayment requirement, you won’t get any policies for yourself.

What are the Best Health Insurance Plans with No copayment in India?

Conclusion

Health insurance policyholders are often torn between choosing

• A plan that comes with copayment options, is beneficial in the short term and is a financial disaster, in the long run, owing to copays over hospital bills, or
• A plan that offers no copayment options that seeks higher premiums, but mitigates any financial worries during hospitalisation

And as health insurance experts, we always say, the latter is always the best choice. So, given a choice, and if it caters to your tailored medical and financial requirements, choose the best health insurance plans with no copayment.

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