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6 Things to Know About Health Insurance Deductibles

Navigating the world of health insurance can be a particularly difficult process. Not only do you have to worry about the costs of premiums but also what you will be expected to pay for co-pays as well as your deductible. Depending on the type of health insurance plan you choose, your deductible can be high or low and might have different expenses that count towards it. 

When looking at your health insurance plan, the co-pays are fairly straightforward with a designated amount required to be paid for each doctors appointment, urgent care visit, or prescription medication. Though, when it comes to deductibles, it can become much more complicated. Before you make your health care plan determination be sure to consider the six things about health insurance deductibles listed below.

Even When Paying on Your Deductible You Will Enjoy Lower Costs

Even though you may have to pay the total cost of a service until your deductible is met, you still will pay a lower price by having insurance. Your insurance company will have negotiated rates with the providers that they use. By having insurance through that company, you are entitled to receive the same discounted rates that the insurance company would if they had paid for it. On average, without insurance, you will pay almost twice as much. 

Healthcare Deductibles Are Not the Same as Other Deductibles

You will encounter deductibles in many types of insurance such as auto insurance, renter's insurance, and home owner's insurance. Health care deductibles are not the same as the deductibles for other types of insurance. With health insurance, you will be billed after the service was completed for the percentage that is deductible-based. With property or car insurance, you will be responsible for paying the deductible before you can receive the services such as car repair. 

All Marketplace Plans Will Cover Preventative Care

There used to be many healthcare plans that would have preventative services go towards the deductible. With more recent changes in healthcare, now all marketplace health insurance plans will provide coverage for preventative services such as well visits, immunizations, and health screenings without requiring you to satisfy the deductible first. Many plans will even cover prescription medication and office visits without requiring deductible payments.


Healthcare guidelines put a maximum for out of pocket costs that a person will pay per year for health costs. The maximum cost per year is $6,350 for an individual, or $12,700 for a family. This means that even if you have a high deductible, your total co-pays, deductible costs, and co-insurance amounts cannot exceed a specified amount per year. What you pay towards your deductible will go towards this amount. Meaning, if you have a high deductible plan, you may not have many more expenses once it is satisfied.

70% of Marketplace Plans Have Deductibles Less Than $3,000

Even though you will often need a higher deductible to ensure a lower premium, most plans available on the marketplace have a deductible that is less than $3,000 for an individual. It is crucial to remember that while choosing a deductible you can afford is important, you also need to make sure what services require the deductible to be satisfied first.

Your Deductible Will Start Over at the Same Time Each Year

Your annual deductible is the set amount you have to pay out of pocket for the year before certain services are covered. This amount will renew each year on the same date that your policy renews. This is important to remember because if you know, you will need testing or deductible based services and can schedule them in the same plan year you can possibly save money if you have already satisfied most of your deductible.

By understanding how health insurance deductibles work, you can ensure that you choose the best plan that can fit your budget and your healthcare needs.


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