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Health Insurance Deductible
Your health doesn’t take a backseat just because you’re abroad, nor should your protection. Niva Bupa NRI Health Insurance is designed specifically for Non-Resident Indians, offering you and your loved ones in India seamless access to quality healthcare, minus the financial stress.You're never far from reliable medical support.
10,400+ cashless hospitals
A swift 30-minute cashless claim process
Trust of over 1.4 crore satisfied customers
Why Choose Niva Bupa?
Still Need Reasons? Here They are:
Trusted by over 1.4 crore Indians, we combine reliability with innovation to keep your health safeguarded, always.With 10,400+ cashless hospitals and a 30-minute claim process, quality healthcare is truly accessible and stress-free.

30 min
Cashless Claim Processing 1

15 Lakh+
Claims paid since inception 2

1.4 Crore+
Happy customers served till date
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How does Our Claim Process work?
Get to know the steps involved in the claim Process, Whether it is a planned or emergency hospitalisation. Filling a claim is made easy by choosing any of the following ways:

Hospital Admission:
Get admitted to a Niva Bupa network hospital.
Identification:
Present your Niva Bupa Health Card or policy number along with valid ID (Passport/PAN card/Voter’s ID) to the hospital staff.
Pre-authorisation:
The hospital will verify your details and submit a pre-authorisation request to Niva Bupa.
Niva Bupa Confirmation:
After verification, Niva Bupa will confirm coverage to the hospital via fax and email, and notify you by text and email, typically within 30 minutes of the request.
Final Settlement:
Upon completion of treatment and necessary formalities, the hospital will settle the claim with Niva Bupa according to your policy terms.
What is Deductible in Health Insurance?
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.
Types of Deductibles in Health Insurance
In India, deductibles in medical insurance plans are mainly of two types, namely, compulsory and voluntary. Given below are different types of deductibles offered in the Indian market along with those offered in the international markets:
Compulsory Deductibles
This is a mandatory deductible governed by the insurance company. It is an amount fixed by the insurance company that the insured is required to pay whenever a claim is raised. This can be in the form of a percentage of the sum insured as decided by the insurance company. In the case of compulsory deductible, the medical insurance premium is not lowered.
Voluntary Deductibles
A voluntary deductible is an amount the insured chooses that they would like to pay from their pocket as and when a claim arises. The chosen amount may depend on financial affordability as well as the insured's medical expenses. If the insured goes for a higher deductible, they will be required to pay a lesser premium, and vice versa. This deductible is valid when the insured does not raise claims frequently and wishes to pay a lesser premium for their insurance plan.
Comprehensive Deductibles
A single deductible keeps adding until the insured pays the total amount for their health policy. This type of deductible in health plans applies across all types of coverage. However, this type of deductible is currently unavailable in the Indian market.
Non-comprehensive Deductibles
This deductible is applicable only on specific covers and not the complete policy. This may require the insured to pay an amount before the insurer pays up to meet specific medical expenses and treatment.
How do Deductibles work in Health Insurance?
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.
Advantages of Deductibles in Health Insurance
They help in lowering the medical insurance premium. Furthermore, the insurance company may offer discounts if the insured opts for voluntary deductibles.
It discourages the insured from raising claims with small amounts, which helps the insured earn a No Claim Bonus (NCB) that can be leveraged to increase the coverage of the primary health policy.
The insured can access medical insurance coverage despite the applicable deductibles during medical emergencies or unforeseen hospitalisation.
Disadvantages of Deductibles in Health Insurance
The insured will be required to pay off the medical expenses, even if they do not have the resources to bear the cost. This is because the benefits under an insurance plan with a deductible can only be availed post payment of the deductible by the insured.
In case of a higher deductible, the insured will be required to pay from their pocket, reducing their savings. On top of that, the financial burden can be huge if multiple medical emergencies occur.
Significance of Health Insurance Deductible
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.
Factors Impacting Deductible Amount in Health Insurance Policy
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.
Differences Between Deductible, Co-Pay, and Co-Insurance in Health Insurance
Deductible, co-pay, and co-insurance are vital features of health plans. However, you must understand these terms thoroughly to make a more informed decision.
Deductible
As discussed above, the deductible in medical insurance is a fixed amount that the insured must pay in case of a claim before the insurer clears the remaining coverage. It is an essential feature in super top-up and top-up health plans. After the insured pays the deductible, the insurer will start paying off the exceeding amount.
The insurer shall bear all the medical expenses covered under the policy, per its terms and conditions stated in the policy document.
Co-payment
The co-payment clause works slightly differently. It can either come as an in-built feature in a medical insurance plan or can be purchased as an added benefit. Under this feature, the insured pays a fixed percentage or sum of medical expenses. So, unlike deductibles, which have to be paid once, here, the insured must pay a portion of medical expenses during the time of claim.
Co-insurance
Co-insurance, like a co-payment clause, is the percentage of treatment expenses the insured must pay after paying the deductibles, generally offered as a fixed percentage. The only difference is that the amount is calculated after the deductibles are paid.
The medical insurance premium is undoubtedly lower when the insured chooses a higher deductible. But it can be useful in case of several medical emergencies. Of course, the insurance company will bear the most claim amounts. Still, if the insured does not have a prolonged illness or expects any medical expenses, they can choose a higher deductible and enjoy lower medical insurance premiums.
Higher or Lower Health Insurance Deductible: What to Choose?
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.
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