Understanding the Basics of Health Insurance Deductibles
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Introduction
Health insurance deductibles are one of the most important aspects of your health insurance policy. They’re also one of the most confusing, and they can be difficult to understand. A deductible is the amount that you must pay before your health insurance covers any medical expenses. If you have a high-deductible health plan (HDHP) and need to see a doctor, you’ll have to pay for at least some of your visit out of pocket first.
What is a health insurance deductible?
A deductible is the amount you pay before your insurance company starts paying. For example, if you have a $1000 deductible and get into a car accident, your insurance company won’t cover anything until they’ve paid out $1000 in claims (unless there are exceptions).
Some health plans have higher deductibles than others. Depending on your plan, this could mean that you pay more for healthcare services each year or it could mean nothing at all–it depends on whether or not someone has met their annual deductible yet throughout that year’s coverage period.
If a person has met their annual out-of-pocket maximum (see below) but hasn’t yet met their medical expense threshold–the point at which they have used up enough of their health care allowance to be eligible for catastrophic coverage–then that person may still be required by law (depending on where they live)
Affordable Care Act (ACA) health insurance deductibles
The Affordable Care Act (ACA) imposes higher deductibles for all plans, except those that are gold or platinum. Under the ACA, you’ll be paying more out-of-pocket before your insurance kicks in.
The table below shows how much you’ll pay for your health insurance deductible based on whether it’s an individual plan or family plan and which metal level it falls under:
Common questions about health insurance deductibles
- What is a deductible?
A health insurance deductible is the amount you pay out-of-pocket before your insurance coverage kicks in. The higher your deductible, the lower your monthly premium will be (and vice versa). For example, if you have a $5,000 annual deductible and need to see a doctor once per month for five months during the year for minor ailments like colds or sprained ankles–that’s 10 visits total–you would pay 100% of those costs yourself until they add up to $5,000. Then once that threshold is met, your plan starts paying 80% of all eligible expenses until its maximum out-of-pocket limit ($7000) has been reached; after which point there are no more copays or coinsurance payments due under any circumstances.*
Health insurance deductibles are essential to understanding how healthcare coverage works.
Deductibles are the amount you pay out of pocket before your insurance kicks in.
For example, if your deductible is $1,000 and you need to get an MRI scan that costs $1,200, you’d have to pay for the first $1,000 of that bill yourself. Then your insurance would pay for what was left over (the other $200).
The amount of each person’s deductible varies depending on his or her plan–it could be anywhere from $0 all the way up to several thousand dollars per year (or even more). Some plans don’t have deductibles at all; others do not require one until after meeting a higher threshold on medical expenses during a given year.
For example: If someone has a plan with no deductible but has already spent $5K out-of-pocket this year under another part of their coverage such as prescription drugs or mental health services–then they may still have a high annual out-of-pocket maximum ($7K), which means they could reach their maximum spending limit before reaching their deductible limit!
Conclusion
Health insurance deductibles are one of the most important features of any health plan, but they can also be confusing. The good news is that understanding how they work will help you make better decisions about coverage and keep yourself healthy in the long run. If you’re looking for more information about how this works or what types of deductibles are available, contact us today!
