# Mandatory Co-Pay Could Raise Costs for Policyholders

> Health insurance co-pay changes may increase out-of-pocket expenses for patients.
- Title: Mandatory Co-Pay Could Raise Costs for Policyholders
- Summary: Health insurance co-pay changes may increase out-of-pocket expenses for patients. The General Insurance Council plans a 10% mandatory co-pay for retail…
- Keywords: general insurance council, mandatory co-pay, retail health insurance, patient contribution, rs 5 lakh, hospitalization claims, business, money, news, Mandatory, Co-Pay, Raise
- Source: Financialexpress — https://financialexpress.com/money/how-mandatory-co-pay-could-be-painful-for-policyholders-4356089
- Author: Saikat Neogi
- Published: 2026-10-08T00:13:49+00:00
- Read time: 1 min
- Topics: general insurance council, mandatory co-pay, retail health insurance, patient contribution, rs 5 lakh, hospitalization claims, business, money, news
## Mandatory Co-Pay Proposal
The General Insurance Council reportedly considers a 10% mandatory co-pay for retail health insurance plans, with patient contributions capped at Rs 5 lakh per claim.
## Co-Pay Mechanism Explained
Under a voluntary co-payment arrangement, policyholders bear a specified percentage of inpatient hospitalisation costs, ranging between 5% and 20%.
## Co-Pay Benefits and Risks
Co-pays benefit those with low claim frequency and stable health but may lead to higher out-of-pocket expenses during major hospitalizations.
## Mandatory Co-Pay Impact
The mandatory co-pay cannot be waived or reduced and applies to all retail indemnity products, regardless of cashless or reimbursement procedures.
## Senior Citizens' Challenges
Senior citizens with high hospitalization claims may face significant out-of-pocket costs under mandatory co-pays, especially with pre-existing conditions.
## Zone-Based Co-Pay System
Health insurers classify locations into metro and non-metro zones, with premiums adjusted based on healthcare costs in different regions.
## Deductible vs. Co-Pay
Deductibles require policyholders to pay a set amount before insurance coverage kicks in, while co-pays are a percentage of the claim.
## Key takeaway

The General Insurance Council plans a 10% mandatory co-pay for retail health insurance, capping patient contributions at Rs 5 lakh per claim, potentially raising costs for policyholders with large hospitalization claims.