The need for health insurance cannot be overstated
If you want to remain healthy and safe, you need the right, affordable health insurance. This will ensure that you get both routine and critical medical care at the right time. Though health insurance substantially reduces your out-of-pocket medical expenses, it does not eliminate them entirely.
Almost all medical care requires cost-sharing, which means you must cover a portion of the expenses yourself. One of these personal costs is your deductible. A deductible is a specific cost burden associated with certain medical procedures or services.
What is a deductible?
In order for your health insurance to cover the remaining costs of care, you must pay a deductible. By sharing some costs, insurers can continue offering affordable premiums and more expansive coverage to their policyholders. Deductibles are designed to reduce the cost burden posed to medical insurers.
The deductible on your health insurance plan, for example, may be $3,800 per year. You will have to pay up to $3,800 out of pocket before your insurance will cover certain health care costs. In this example, if you received a $6,000 surgery bill, you would pay $3,800 and your insurance would cover the rest. Once you have paid off your deductible, the deductible obligation will begin again.
Is there a deductible for every medical expense?
There are some health insurance plans that require you to pay 100% of the costs of care until you have met your deductible.
The following medical expenses are exempt from the deductible obligation:
- Regular checkups
- Medically necessary services
- Preventive care
Regardless of whether you still owe money on your deductible for a checkup, lab work, vaccination or other routine care, you may only need to pay the necessary copayment or coinsurance for these exempt expenses. As a result, you can still receive the care you need to stay healthy without having to shoulder an undue amount of money.
Your deductible will often apply to certain care costs, such as inpatient care expenses, certain imaging services or other care that your insurer might not deem medically necessary. Review your explanation of benefits document to see exactly how and when you must pay your own deductible. This document will detail your specific deductible obligations.
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