Get More Benefits &
Save More! Call For
More Info Today

What Is a Deductible With Health Insurance?

A deductible is a particular dollar amount your health insurance plan may want you to pay out of pocket toward covered medical care each year before your health plan starts to pay for covered medical expenses.

Your annual deductible can differ significantly from one health insurance plan to another. Plans with higher metal levels (like “gold” or “platinum” plans) tend to have a lower annual deductible but higher monthly premiums. Plans assigned lower metal levels (such as “bronze” plans) tend to have lower monthly premiums but higher annual deductibles.

Most health insurance plans will pay for certain services – such as a check-up, physical, or a disease management program – before you have meeting your annual deductible.

All marketplace plans will pay the entire cost of certain preventative benefits, as mandated by the Affordable Care Act.

Also, bear in mind that family plans typically have an individual deductible, which applies to every individual, and a family deductible that applies to the whole family.

Is It Probable To Be Insured With No Deductible?

Yes, it is possible to get a health insurance program with no deductible!

Some plans (normally HMOs) do not have a deductible at all. These plans are known as zero-deductible plans. Zero-deductible plans usually come with higher premiums, while high-deductible plans typically come with lower premiums.

If you regularly visit doctors or take multiple medications, a zero-deductible plan may suit your budget and coverage needs

High Deductible Health Insurance and Health Savings Accounts (HSAs)

Health insurance plans with high-deductible and low-premiums may be ideal for individuals who are generally healthy, do not anticipate getting hurt, and do not frequently visit the doctor. While low-premiums may seem appealing to many health insurance consumers, it is significant to consider the number of healthcare services you may need in the upcoming year for yourself or any dependents you may have. If you choose a high-deductible plan, you may be qualified for a Health Savings Account (HSA). An HSA lets both you and your employers deposit a limited amount of pre-tax dollars into this account for medical expenses.

“No Charge after Deductible” Meaning

This means that after you have paid your deductible for the year, the insurance company will commence and pay 100% of the rest of your covered medical costs for the year. In this situation, you will not have a copay or have to pay a coinsurance.

In many health insurance plans, the health insurance carrier (also known as provider or company) usually only pays 100% of covered medical costs after you have reached your out-of-pocket maximum. This threshold is a similar idea to your deductible, except usually higher — meaning you have to spend more dollars on covered medical expenses before reaching it.

Resources and References:

• Advantages of a Health Savings Account
• Marketplace Health Insurance Plans