Health Insurance Terms: Deductible and Co-insurance Explained
Understand what a deductible and co-insurance mean and how they affect your medical costs before your insurer pays.
What Is a Deductible in Health Insurance?
A deductible is the initial amount you have to pay for your medical expenses before your health insurance makes a payout. This means you must cover this first portion of costs out of your own pocket before your insurer begins to share the expenses.
What Is Co-insurance?
After paying your deductible, you may still have to pay for co-insurance or co-payment. For example, if you have a co-insurance of 10%, you will pay 10% of the cost after the deductible. The remaining percentage is typically covered by your insurance policy, according to its terms.
How Do Deductible and Co-insurance Work Together?
When you receive medical care, you first pay the deductible. Once that is met, co-insurance applies. For example, if you have a co-insurance of 10%, you will pay 10% of the cost after the deductible.
Using MediSave for Deductible and Co-insurance
You can use MediSave up to prevailing limits to pay for the deductible and co-insurance not paid by your insurance policy. This can help manage your out-of-pocket expenses, within the limits set by the Central Provident Fund (CPF) Board.
Note on Pre-existing Conditions
Health insurance policies do not usually cover pre-existing conditions when you sign up for them. This is a general practice in Singapore, so it’s important to understand what your policy excludes.
Frequently Asked Questions
Do I always have to pay a deductible?
Most health insurance policies in Singapore include a deductible. The exact amount depends on your plan, such as whether you choose a private hospital or public hospital ward class.
Is co-insurance the same as co-payment?
Co-insurance refers to a percentage of the cost you pay after the deductible, while a co-payment may be a fixed amount. Both are forms of cost-sharing, but the terms can vary by policy.
Can I use MediSave for all deductibles and co-insurance?
MediSave can be used up to prevailing limits. There are specific withdrawal limits for different treatments, so check your CPF balance and the applicable limits for your medical procedure.