
Even in network hospital and 3 day prior intimation???

Yes I paid it yesterday for my mother, I did the 72hrs of prior intimation still they asked me to pay. I had a long argument with medi assist team for it for two reasons 1st one : They charged me directly without information when I asked they said you will be getting notified shortly. 2nd One : we people are paying hefty amount for our parents insurance , still why the hell they are charging again a Co-Pay amount to us?? This is not acceptable for my view what others are thinking??

HIS portal is not letting me delete the nominee without uploading a deceased certificate for nominees and this i am being forced to pay the extra insurance premium

Co-Pay--> Newly introduced in 2024, Silver 5%, Gold 7.5%, Gold Plus 10% and so on. But there is a max limit of co-pay, Silver Rs 5000, Gold Rs 7500 and so on. Let's assume you have a gold plan and your hospitalization bill is 10 Lakh, so 7.5% of co-pay is Rs 75 thousand but you have to pay Rs 7500 as it's a max limit of co-pay per hospitalization claim.

now for hospitalization either cashless or reimbursement you need to pay 5% - 15% depending on your plan with a max limit. in case you opt of reimbursement in a network hospital or do not intimate 72 hrs prior to a planned hospitalization, this will be in addition to the 10% co-pay.

So. COpay is for hospitalisation only or also for domicile reimbursement also we got to copay??


Copay means that the beneficiary will be required to pay a certain percentage of total hospitalization amount. For now they have introduced the copay of 7.5 % for gold plan . Which means the beneficiary will have to pay 7500 rs if the hospitalization amount is 1 lakh rupees. But there is Max co pay limit of 10k. So the max employee will pay is 10k for gold plan.
