Imagine you buy a health insurance plan with a ₹5 lakh cover for ₹7,000 a year. The agent offers a deal: cut your premium by 25% if you accept a 20% co-payment clause. You save around ₹1,800 upfront—sounds great, right?
Fast forward nine months. You have an accident and the hospital bill is ₹2 lakh. Your insurer pays only ₹1.6 lakh, and you must pay ₹40,000 out of pocket because of the co-payment. Suddenly, that ₹1,800 premium saving feels tiny compared to the big unexpected expense you must cover.
Doing the math, it would take over 20 years of premium savings to make up for this one co-payment bill. Not worth the risk when costs can balloon in real situations.
Co-payment clauses rarely make sense unless you’re forced to have them (like for older people with pre-existing conditions). In those cases, co-payments can help lower premiums significantly, which might be necessary.
But for most healthy people buying health insurance in India, it’s better to avoid co-payment clauses and pay a slightly higher premium. This way, you get better financial protection without the shock of big out-of-pocket payments when you need care most.
Choosing the right health plan means thinking beyond the premium price and understanding how clauses like co-payment affect your real costs. Protect yourself from nasty surprises—say no to co-payment unless it’s a must for your situation.