The amount you pay for covered health care services before your insurance plan starts paying is known as a deductible. This is the amount of money a member pays out-of-pocket before they are required to pay a copay or coinsurance. This amount goes towards the maximum amount of out-of-pocket expenses. When selecting a health insurance plan, it is important to consider the deductible structure, as this will determine when the company actually starts paying.
Every health insurance plan offers an individual deductible and a family deductible, and the family deductible is usually double that of a person. For example, if you have a chronic health condition that requires regular visits to your primary care doctor and specialists, you may want to select a plan with lower deductibles to quickly reach your limit and the health company will start paying your expenses. High-deductible health plans (also called consumer-driven health plans) have a higher deductible than traditional health plans. The health insurance deductible is the dollar amount you must pay before the health insurance company begins to cover many of your health care services and, depending on your plan, before you can use the benefits of coinsurance and copay.
If you're in good health and don't have any health problems, you might not even spend enough to cover your plan's deductible for the year. The deductible must be paid again next year before the insurance plan begins to cover the costs if the policy is renewed. Understanding how deductibles work is essential when selecting a health insurance plan that best fits your needs. Knowing what type of coverage you need and how much you can afford to pay out-of-pocket will help you make an informed decision.
Comparing deductibles, coverage offered by the plan, and how often you need medical care are all important factors when selecting a plan.