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What’s a Deductible on Health Insurance?

Modified on August 23, 2020 at 10:42 PM

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What’s a deductible on health insurance? Get clear, easy to understand answers in this this straightforward guide with exactly what you need to know.

In 2018, more than 91 percent of Americans had some type of health insurance, but only a fraction of that number truly understands how their policies work. No matter what type of coverage you have, you’ll have to pay a deductible to your insurance company.

If you’re like most people, you’re probably asking yourself, “what’s a deductible, anyway?” You’re not alone.

Though deductibles are a standard feature of health insurance plans, they’re a bit confusing for people to figure out. Here’s what you need to know about this aspect of your health insurance coverage.

So, What’s a Deductible on Health Insurance, Anyway?

Health insurance deductibles work differently than other types of insurance deductibles. For example, when you file a claim with your auto insurance provider, you’re expected to pay the deductible up front anytime you file a claim.

That deductible will typically be a few hundred dollars and helps offset the cost of repairs for any damage your car suffers.

The deductible on your health insurance plan is the amount of money you pay out-of-pocket for the medical care you receive. However, the amount you pay doesn’t offset the amount your insurance provider pays. Instead, it’s what you’re responsible for before your insurance company will kick in and cover the rest of your treatment costs.

The exact amount varies based on the type of health insurance you have and the number of people on your plan. The more people you’re covering through an insurance policy, the higher your out-of-pocket expenses will be.

How It Differs From Co-Pays

Your deductible is your responsibility to pay in full. However, your insurance provider will still get you discounted treatment prices before you pay the full amount. They do this in part through a system of co-pay amounts.

The co-pay amount is what you pay to your doctor at the time of your appointment. This is the amount that helps off-set the cost of your treatment and makes it easier for the insurance company to cover the portion of your treatments they’re responsible for.

Most insurance companies require co-pays for standard check-ups and routine examinations.

If you undergo treatments that cost an additional amount, the billing department at your doctor’s office will help determine what you owe. They’ll reach out to your insurance provider to see how much of your treatment they’ll cover and then send you a bill for the remaining amount.

What Happens If You Don’t Meet Your Deductible

With other types of insurance, you’re required to pay your deductible if you want to file a claim. If you don’t make that payment in full, you won’t be able to file the claim successfully.

Health insurance is different.

You’re not required to pay the full amount of your deductible to use your health insurance throughout the year. Your insurance provider will still help you avoid having to pay the full price for the medical treatments that you receive.

It just means they’ll cover less of the cost than they would if you meet your full deductible amount.

Once you pay the deductible, your insurance company will cover a higher percentage of your medical treatments’ costs. Some plans even cover the full cost of the treatment for the remainder of the calendar year.

At the end of the year, the deductible resets. You’ll have to pay that amount out-of-pocket again before the insurance company will pay the bulk of your treatment costs.

How Providers Set Health Insurance Deductibles

Ultimately, the higher your deductible is, the lower your monthly premium payments will be. This will make it easier for you to pay for insurance throughout the year.

Insurance companies base the cost of their deductibles on the amount you pay each month. If you enroll in a plan with higher monthly premium payments, they’ll reduce the amount of your deductible. If you enroll in a plan with low premiums, they’ll make up the difference with a higher deductible.

Think about how often you tend to use your health insurance. If you have underlying health conditions or go to the doctor often, paying a higher premium for a lower deductible amount is in your best interest. However, if you don’t go to the doctor often, you’ll end up saving money with a lower premium amount.

Remember, you have to get medical treatment to start paying down your deductible. If you don’t go to the doctor often, you won’t benefit from a low deductible.

There Can Be More Than One Deductible on Your Plan

Unfortunately, health insurance companies break coverage up into different categories. You can have one deductible for standard healthcare and another for prescription medications.

This is both legal and normal. Take your time and review the deductibles on your current insurance policy. The more deductibles you have on your plan, the more money you’ll spend out-of-pocket.

What You Need to Look for When Shopping for Coverage

You’ll want to compare different plans and coverage levels when shopping for health insurance. This is true whether you’re getting it through the marketplace or enrolling in Medicare. Take your time and review these plan options in detail.

Look at the monthly premium amounts you’ll pay for your insurance. Then, compare the deductible rates you’re responsible for.

The best plans will have affordable premium rates that fit your monthly budget as well as affordable deductibles. Keep in mind that those deductibles will likely be significantly higher than the ones you’d find with other types of insurance policies.

Demystifying the Health Insurance Deductible for Good

Now that you’ve figured out what’s a deductible and how it works for your insurance coverage, you’re ready to take advantage of your health insurance policy in earnest. Just make sure to review every bill you receive.

Keep track of the money you pay toward your deductible throughout the year. This way, you’ll be able to make sure your insurance provider fulfills their end of the bargain.

Looking for tips to help you get the most out of your health insurance? Check out our latest posts.

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Posted By The Fashionable Housewife
on August 22, 2020 at 10:42 AM
Filed Under: Health & Fitness
Tagged With: Health, health insurance, insurance, insurance company

About The Fashionable Housewife

Sarah-Jean Ballard is the Editor in Chief of The Fashionable Housewife blog and Founder of Fashionable Media. Married to a sexy Molecular Biologist, housewife, mom to 5, homeschooler, Certified Personal Nutritionist and entrepreneur who's mission is to help moms just like you look and feel GREAT! Other interests include dancing, yoga, positive intactivism, natural birth and breastfeeding support, babywearing, paleo & gluten-free cooking, and promoting an overall healthy lifestyle to all.

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I miss summer already 😭 Take me back to a bett I miss summer already 😭

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Somebody hold me. 😭

I asked him if he could stay 12 for one more year but he didn’t like that idea. 😒 Was worth a shot, right? 

Scroll for the outtakes 😂😂😂

This kid blows me away daily and makes me so proud to be his mom. I don’t have enough words to describe how much I love this child. 😭

Drop a comment and wish this boy a happy birthday! 🎉🎂 

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Luckily, there are holistic wellness products that can help make the motherhood journey easier!

Lost Empire Herbs stands out as a remarkable family venture led by three health-conscious brothers who share a profound dedication to a wholesome, active lifestyle. 

Their journey began with a modest kitchen table and the introduction of pine pollen, but it has since evolved into something truly remarkable, exceeding all expectations.😱

What truly sets Lost Empire Herbs apart is their extensive collective knowledge, derived from years of hands-on experience, unwavering commitment, and a willingness to explore new horizons. Driven by a genuine desire to enhance lives, they made a resolute decision to make the benefits of these exceptional herbs accessible to a wider audience. 

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Story Land in Glen NH is a great way to make some beautiful summer memories with your family! If you live in the New England area, definitely plan a visit before summer slips through your fingers, mama! ☀️ 🏖️ 

LIKE + SHARE if you needed this reminder to slow down and have fun! 

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COMMENT and tell me which part your kiddos would like the best! 👇🏻

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I miss summer already 😭 Take me back to a bett I miss summer already 😭

Take me back to a better place 👉🏻 summer time at @storylandnh !! 🥳🥳🥳🥳

Can’t wait to go again next year! 🙌🏻✨🤸🏻‍♀️

#summertime #familytime #familyadventures #motherhoodunplugged #childhoodunplugged
What they remember about their childhood is in you What they remember about their childhood is in your hands 🫶🏻

#motherhood #motherhoodrising #motherhoodunplugged #motherhoodthroughinstagram #motherhoodintheraw
This is what our homeschool looks like sometimes. This is what our homeschool looks like sometimes. 🥳

Can’t believe my oldest son is 13 and outside helping dad do home projects like building a new deck. 🤯 Seems like yesterday he was in his walker on this back deck and it looked a lot better 😂

Thankful that @homedepot has great prices so we could finally afford to do this home reno project! 💪🏻🎉

#motherhood #motherhoodunplugged #hereisourhomeschool #motherhoodthroughinstagram
My first born son turned 13 years old today. 😱 My first born son turned 13 years old today. 😱

Somebody hold me. 😭

I asked him if he could stay 12 for one more year but he didn’t like that idea. 😒 Was worth a shot, right? 

Scroll for the outtakes 😂😂😂

This kid blows me away daily and makes me so proud to be his mom. I don’t have enough words to describe how much I love this child. 😭

Drop a comment and wish this boy a happy birthday! 🎉🎂 

#homeschoollife #homeschoolfamily #momlife #momlifeunfiltered #momlifeunplugged
Being a mom is hard. Being a mom and trying to sta Being a mom is hard. Being a mom and trying to stay healthy and fit is harder. 🏋🏼‍♀️🥵

Luckily, there are holistic wellness products that can help make the motherhood journey easier!

Lost Empire Herbs stands out as a remarkable family venture led by three health-conscious brothers who share a profound dedication to a wholesome, active lifestyle. 

Their journey began with a modest kitchen table and the introduction of pine pollen, but it has since evolved into something truly remarkable, exceeding all expectations.😱

What truly sets Lost Empire Herbs apart is their extensive collective knowledge, derived from years of hands-on experience, unwavering commitment, and a willingness to explore new horizons. Driven by a genuine desire to enhance lives, they made a resolute decision to make the benefits of these exceptional herbs accessible to a wider audience. 

Their primary focus revolves around offering hormonal support, a vital consideration given the prevalence of endocrine-disrupting compounds in today's world, although their scope extends beyond this singular realm. 🌱 

I'm genuinely enthused about the prospect of trying out their products, eagerly anticipating the chance to personally experience the transformative effects of these wellness herbs. The brothers' evident passion and expertise have left me intrigued and eager to embark on a journey towards total wellness, guided by the offerings of Lost Empire Herbs.

@lostempireherbs #lostempireherbs #holistichealth #holistichealing #holisticwellness #holisticlifestyle #motherhoodunplugged #motherhoodjourney #motherhoodthroughinstagram #unleashthepowerofnature #rootingforyourhealth #hormonehealth @apexdropofficial
Slow down a little and visit @storylandnh !! It s Slow down a little and visit @storylandnh !!

It seems like summer is almost over and you’re probably scrambling to get all the things done on your bucket list. But don’t forget to slow down and have some fun with your kids this summer!!

Story Land in Glen NH is a great way to make some beautiful summer memories with your family! If you live in the New England area, definitely plan a visit before summer slips through your fingers, mama! ☀️ 🏖️ 

LIKE + SHARE if you needed this reminder to slow down and have fun! 

#motherhoodunplugged #motherhoodjourney #momlifeunfiltered #motherhoodrising #motherhoodthroughinstagram
Looking for something fun to do in New Hampshire t Looking for something fun to do in New Hampshire this summer? Living Shores Aquarium in Glen NH is an indoor walk through adventure that allows your whole family to discover the wonders of the ocean year-round. 

The aquarium includes interactive tide pools, exhibits, and tons of immersive activities. See otters, touch sting rays and nibble fish, interact with tropical birds and so much more. They even have axolotls and sharks! There is so much to see. We spent over 3 hours exploring the exhibits! And of course we had to stop in the amazing gift shop before we left. Don’t miss it! 

Living Shores is a fun, interactive environment that is perfect for the whole family! If you’re going to visit the White Mountains this summer, definitely make time to stop at @livingshoresnh! 🐠 🐟 🦀 

COMMENT and tell me which part your kiddos would like the best! 👇🏻

 #familytime #motherhoodunplugged #momlifeunfiltered #whitemountains #familygoals #familyfriendly
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