What is Deductible and Co-Insurance in Medical Insurance?
November 19th, 2008 by ALVIN SOONG
1) The deductible is the portion of a claim that the policyholder has to bear before the insurer pays any benefits. It is usually between $1,500 and $4,500.
For example, if you are under Plan Preferred of NTUC Income’s hospitalisation Enhanced Incomeshield, the deductible is the first $3,000 of a claim.
2) Co-insurance is a fixed percentage of the claim - what is left after the deductible is accounted for - that a policyholder bears. This feature means that policyholders share part of the cost of the bill, usually 10 per cent over and above the deductible.
Say you have a health policy with a $1,500 deductible and a 10 per cent co-insurance. If your claim is $5,000, you must pay the deductible of $1,500 plus 10 per cent of the remaining $3,500, or $350, in co-insurance. So you pay $1,850, while the insurer takes care of the remaining $3,150.
Max Co-insurance limit that one needs to pay is $3000.
You can use only cash to pay the premiums, but main plan can be paid by medisave if there is sufficient amount in the CPF medisave
Summarised from Sunday Straits Times 16th Nov 2008
