Co-pay

Co-pay is the portion of each claim you agree to pay out of your own pocket. A policy with a 10% co-pay pays 90% of an approved bill and leaves 10% to you.

How it works

The co-pay applies to every approved claim, as a fixed percentage. On a ₹4 lakh hospital bill with a 10% co-pay, the insurer pays ₹3.6 lakh and you pay ₹40,000, even though your sum insured may be much higher. It is a way of sharing cost: you carry a slice of each claim, which is why a co-pay reduces your premium.

The trade-off

A co-pay is a classic premium-versus-protection choice. A higher co-pay means a lower premium now, but a bigger bill exactly when you are already dealing with a hospital stay. A lower or zero co-pay costs more upfront but leaves you less exposed at claim time. For a young, healthy buyer a small voluntary co-pay can be a reasonable way to cut cost; on older policies it is often compulsory.

Watch for it in the fine print

Co-pay often appears quietly in two places: on senior-citizen plans, where it is frequently mandatory, and on policies covering treatment in a higher-cost city or a non-network hospital. It stacks with other limits like a room rent limit, so two features together can shrink a payout more than you expect. Always read how the co-pay is applied before buying, and see how much health cover you need.