Health Insurance Deductible

A health insurance deductible is a fraction of the medical/hospitalisation expenses the insured must pay out of their pocket before making an insurance claim. The insurance company shall pay the claim amount directly to the hospital only when the insured pays the deductible amount. 

In other words, the insurance company shall only cover the claim if it exceeds the deductible amount. Any claim under the insurance deductible will be rejected. The deductible amount is added as a clause in medical insurance plans to ensure there are no scams or frauds and people raise only genuine claims.

Deductibles in insurance act as an obstacle to raising small and ingenuine claims just because there is insurance coverage. While there may be a lower premium, the deductible in a health insurance plan can be higher. This may deter the insured from raising small claims and losing out on the No Claim Bonus (NCB). Hence, people are prompted to raise a claim only in case of higher medical expenses and not for minor expenses. Furthermore, since the insured needs to pay the deductible before the insurance provider covers the remaining sum insured, any unnecessary claims are eliminated, and the insurer covers only rightful claims.

The deductible amount to be paid by the insured is mentioned in the policy's T&C. Let's understand its significance:

• Deductibles have been implemented to safeguard the insurance providers' interests from people who do not file genuine health plans claims or make claims for small amounts
• It prevents policyholders from making unreasonable claims and instead helps them realise they need to use their insurance for critical cases.
• The probability of fraudulent claims will reduce significantly with a health insurance deductible.
• A higher deductible amount can be a disadvantage; when the claim amount is lesser than the specified deductible amount, the insured will have to bear the costs from their pocket. Hence, one should pay the utmost attention and thought while buying a health plan.

While understanding the notion of health insurance deductible is crucial, the factors impacting its calculation are equally essential. Below are some points to consider while deciding the deductible amount:

• Present health conditions
• Past medical history
• Pre-existing diseases
• Lifestyle-smoking/tobacco

Consider how a deductible can benefit you if you haven't opted for a health plan yet or your renewal is due.

One must assess their condition and family requirements while choosing a medical insurance deductible. Below are some factors to consider:

Analyse your health care expense: The primary aspect to consider while choosing a deductible is the total amount of your anticipated medical expenses. In addition, it would be best to look for your medical records focusing on hereditary illnesses and personal history of diseases.

Analyse your current health and future needs: You should consider the current health conditions of your family members while choosing a deductible. In addition, it would be best to plan out your future health needs concerning infant care, pregnancy, elderly parents staying with you, etc.

You should pick a high deductible plan if you are a healthy person with no immediate medical needs and low medical expenses. This is good for young individuals and families, who may not be able to bear a high premium upfront but can afford to have a delayed cover.

However, you need immediate cover in case of pregnancy, elderly, a history of severe illnesses, future surgeries, or high medical expenses. A lower deductible insurance plan has a high premium but provides earlier protection, thus suitable for anyone with higher and recurring medical expenses.

Get the best health insurance policy from Niva Bupa at an affordable premium and deductibles to minimise the burden of high treatment costs.