Health Insurance Deductibles Explained
What is a health insurance deductible?
A deductible is the amount you pay for covered services before the plan begins paying its share for those services. Not everything applies to the deductible — many plans cover certain preventive services and some copay-based visits before it is met.
A deductible is not a fee you pay upfront. It is a threshold you cross through actual spending on covered care.
Plans differ in what counts toward the deductible. Prescriptions may have their own rules, and preventive services are commonly covered without applying it.
A higher deductible generally comes with a lower premium, and the reverse. That is a tradeoff about when you pay, not about whether you pay.
Important exceptions
- Family plans may apply individual and family deductibles differently.
- In-network and out-of-network deductibles are often separate amounts.
- Some services are covered before the deductible under many plans. Check the specific plan documents.
Dave's perspective
“A high deductible is not automatically a bad plan. It is a bad plan for someone who cannot comfortably absorb that amount in a difficult year.”
Dave Gagleard · Dave Knows Health
Related information
Plan availability, eligibility, benefits, exclusions, underwriting requirements, enrollment periods and coverage vary by carrier, product and state.