How Dual Insurance Can Help You Avoid Co-pay and Co-insurance Costs

There is a general belief among Indians that once they purchase a health insurance policy, they need not pay anything on treatment for an ailment, disease or injury as long it is covered under the plan. With more and more insurance companies providing cashless option to its customers, even the worries related to reimbursement claims are beginning to diminish.

That is the reason why many Indian students who go overseas to countries like the US end up getting a rude shock when their student health insurance provider asks them to pay a portion of the medical bill from their own pocket. Most of them are either ignorant of terms like ‘deductibles’, ‘co-payment’ or ‘co-insurance’ or have a limited understanding about their applicability.

However, unlike India, sharing the cost of treatment between the insurance provider and the client is a common practice in the US. A customer is required to pay an amount ranging from $20 to $500 as deductible or co-payment either per treatment or annually. Additionally, they are also required to share a certain percentage (10 to 30 percent) of the treatment cost as ‘co-insurance’ with the insurance provider.

How to avoid paying the amount under co-payment & co-insurance for any medical bill?

In this blog, Student Cover guides you on how you can avoid paying co-payment and co-insurance through Dual Insurance. If you are new to terms like Deductibles, Co-payment, and Co-Insurance, you can click on the link to our previous blog titled ‘Cost-sharing under Health Insurance plans’ to learn more about how the cost-sharing concept works in the US.

As you already know, due to high cost of treatment in the US, it is mandatory for all international students to get themselves covered by a credible health insurance plan in that country. Students can do this by either enrolling for a university sponsored student health plan or by purchasing an alternative health insurance from a external vendor.

Sadly, many universities in the US have made it mandatory for students to subscribe to their own sponsored plans. These university sponsored plans are not only expensive, but also have Co-pay and Co-insurance conditions that require students to bear a portion of total medical expenses from their own pocket.

For example:

The cost of treatment even for minor illnesses such as cough & cold, fever or stomach infection in the US could well be over $1,000. The university plans usually have 10% to 30% co-insurance condition. This means that for a treatment costing $1,000, a student would have to bear 10% to 30 % of the cost i.e. $100 (Rs. 14,000) to $300 (Rs 21,000) from their own pocket before the insurance company pays the remaining 90% ($900) to 70% ($700) of the cost.

Treatment for major illnesses such as operations for appendicitis, kidney stone or knee fracture can cost up to $50,000. Co-insurance obligation, even of 10%, means that a student will end up paying $5,000 (Rs. 3.5 Lakhs). This can cause additional financial burden on the student and his or her parents, especially if they have already taken education loan from the bank to finance the student’s higher studies.

Therefore, in order to provide relief to such students, Student Cover offers Dual Insurance option through its partner Indian health insurance companies operating in the US. Under this scheme, those students who have already subscribed to university sponsored plans or have taken student health insurance plans from a US based insurance provider, can purchase an additional low cost plan from Student Cover’s partner Indian companies in the US.

These plans provide the same benefits as those provided by University sponsored plans or US based insurance company plans at yearly premium as low as $360 per year. Moreover, unlike the university sponsored plans which only provide health coverage, these plans cover health and travel benefits as well as other major coverage in a single plan.

The main advantage that the students get by purchasing these low cost plans from Student Cover’s partners is that they do not have co-payment or co-insurance obligations. This means that students don’t have to bear any part of the treatment cost. Their expenditure will be limited to the nominal deductible amount of just $100.

These plans even cover the cost of ambulatory services and medicines by including them in treatment cost instead of putting them under a separate section. Also, unlike University sponsored plans or US company plans, a student does not have to search for in-network hospitals as almost all hospitals are covered under these plans.

With regard to settlement of claims, Indian students have an edge over those who purchased US plans as, in addition to claim settlement assistance provided by these plans in US itself, Student Cover too provides assistance on settling claims through its dedicated team of claim settlement specialists.

Below is a brief comparison of the benefits that Indian students enjoy by opting for Dual Insurance through Student Cover.

COMPARISON – For medical treatment bill amounting to $20,000.

University Sponsored or US company Insurance Plan: Deductibles ($ 100-$ 500 per annum) + Co-Pay ($ 20 – $ 300 per treatment) + Co-Insurance cost (10% to 30% of the total medical bill) = $ 2,108(Rs. 1, 47,560) to $ 6,560 (Rs. 4, 59,200)

Student Cover’s partner Indian Company Insurance Plan: Only nominal deductible of $ 100 (Rs. 7,000) per treatment.

Savings: From $2008 (Rs. 1, 40,560) up to $6,460 (Rs. 4, 52,200)

At present, Student Cover offers a Bronze Plan and a Gold Plus Plan. The comparative table below would give more idea of what financial advantages one can enjoy in Student Cover plans as compared to university-sponsored plans.

COMPARISON OF BENEFITS

Benefits                                    University Sponsored Plans     Student Cover Plans

Medical Coverage                                 Yes                                    Yes

Deductible                                            Yes                                    Yes

Copay                                                    Yes                                    No

Co-insurance                                        Yes                                    No

Checked-in Baggage Loss                     No                                     Yes

Personal Accident                                  No                                     Yes

Personal Liability                                    No                                     Yes          

Bail Bond                                                 No                                     Yes

Study Interruption                                    No                                    Yes

Sponsor Protection                                  No                                  Yes

2 Way Compassionate Visit                    No                                  Yes

Loss of passport                                      No                                 Yes

In Network Hospitals (Cashless)            Yes                               Yes

Out of Network Hospitals (Cashless)      No                                Yes

We hope that the information provided on this blog would be useful to you. If you have any queries regarding Dual Insurance, you may contact Student Cover at info@studentcover.in or call [96501 66773].

Disclaimer: Currently, Student Cover provides dual insurance benefits through its partner Indian health insurance companies in the US, to Indian citizens only.