Difference between Co-payment and Deductible 

Health Insurance Plans starting at Rs.15/day*

Health Insurance Plans starting at Rs.15/day*

Are you looking to buy a Health Insurance policy but need help understanding the technical jargon that comes with it?

Someone without insurance knowledge may quickly become perplexed when dealing with concepts like Co-payment and Deductible.

But fret now; we have got you covered.

This article will cover what Co-payment and Deductibles mean and how they affect Health Insurance policies.

What is a Co-payment?

Co-payment refers to the percentage of the medical expense that a policyholder must pay for every admissible claim, and the Health Insurance Company pays the remaining balance.

For instance, the Co-pay clause in your insurance policy requires you to pay 10% of the entire cost incurred. And the total cost of your medical treatment is Rs. 1 lakh. In this case, you will be required to pay 10%, which is Rs. 10,000 and the Insurance Company will cover the remaining 90% (Rs. 90,000).

What are Deductibles?

A deductible is a set amount policyholders must pay before their insurance plan starts paying for their medical treatment. The Health Insurance Company chooses whether to charge Deductibles annually or per treatment.

For instance, if your Health Insurance policy mandates a Deductible of Rs. 5000, you will be responsible for paying all treatment costs up to that amount before your insurance policy begins to pay.

Co-payment vs Deductible

DefinitionCo-payment is the fixed percentage that policyholders must pay toward their medical costs while the Health Insurance Company covers the balance. It may be given as a fixed amount or percentage of the cost of the treatment.The Deductible is the amount that policyholders must pay upfront before their insurance policies begin to pay for a more significant share of the medical expenses.
Effect on premiumWhen the Co-payment is higher, the premium amount is lower.Deductibles also lower the premium amount.
Real-life exampleLet us assume that the Co-payment is 10% of the policy and that the treatment costs Rs 1 Lakh. In such a case, the policyholder will be responsible for paying Rs. 10,000 of the treatment costs, with the remaining Rs. 90,000 being covered by the Insurance Company.In this case, let us assume that the Deductible is Rs. 5000, which the policyholder must first pay for his medical treatment. Only after the policyholder has paid their part of Rs. 5000 will the policy cover their medical expenses.


Your premium payment will be lowered if you choose a policy with such cost-sharing terms. Every time a medical emergency occurs, you will be responsible for paying a share of the costs. If you do not have access to quick cash on hand, this could cause problems.

Considerations for the policy should include the number of family members, age and health risks. Star Health Insurance offers an array of Health Insurance Policies allowing you to choose one that best suits your needs.


The Information including but not limited to text, graphics, images and other material contained on this blog are intended for education and awareness only. No material on this blog is intended to be a substitute for professional medical help including diagnosis or treatment. It is always advisable to consult medical professional before relying on the content. Neither the Author nor Star Health and Allied Insurance Co. Ltd accepts any responsibility for any potential risk to any visitor/reader.

Scroll to Top