Deductible - Glossary (2024)

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

After you pay your deductible, you usually pay only a

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.

Refer to glossary for more details.

or

The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.

Refer to glossary for more details.

for covered services. Your insurance company pays the rest.

  • Many plans pay for certain services, like a checkup or disease management programs, before you've met your deductible. Check your plan details.
  • All Marketplace health plans pay the full cost of certain preventive benefits even before you meet your deductible.
  • Some plans have separate deductibles for certain services, like prescription drugs.
  • Family plans often have both an individual deductible, which applies to each person, and a family deductible, which applies to all family members.

Generally, plans with lower monthly

The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. If you have a Marketplace health plan, you may be able to lower your costs with a premium tax credit.

Refer to glossary for more details.

have higher deductibles. Plans with higher monthly premiums usually have lower deductibles.

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Deductible - Glossary (2024)

FAQs

What is a deductible your answer? ›

and how it works can help consumers make informed decisions when purchasing insurance and filing claims. Simply put, a deductible is the amount of money that the insured person must pay before their insurance policy starts paying for covered expenses.

Which answer best defines deductible? ›

The statement best defines the term deductible is that it is the amount a consumer pays before the insurance will start paying.

Is a $1000 deductible good for car insurance? ›

If you're more likely to get into an accident, you won't want to pay out a higher deductible. However, if you're generally a safer driver, your car insurance premiums will be lower with a $1,000 deductible.

What is 20% of allowable amounts after deductible? ›

Coinsurance – Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay the coinsurance plus any deductibles you owe. If you've paid your deductible: you pay 20% of $100, or $20.

What should I put as my deductible? ›

Your deductible should be an amount you can comfortably cover in case you need to file a claim. Car insurance deductibles usually range from $100 to $2,000, with a $500 deductible being the most common.

What is an example of a deductible amount? ›

Deductible is the amount you pay before your insurance policy starts to pay. For example, with Rs. 30,000 deductible, you pay the first Rs 30,000 of covered services. Insurer will only cover the claim amount if it is more than the deductible amount.

What is the best way to describe a deductible? ›

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.

What is the most common deductible? ›

Most homeowners and renters insurers offer a minimum $500 or $1,000 deductible, and raising the deductible to more than $1,000 can save on the cost of the policy. Of course, remember that you'll be responsible for the deductible in the event of loss, so make sure that you're comfortable with the amount.

How is deductible calculated? ›

Health insurance deductibles are calculated annually, with your expenses over the course of the year adding up until you've hit the limit. Once that happens, your insurance will begin covering some or all of the cost of medical treatment. The amount then resets every January 1.

What is too high of a deductible? ›

Rare a decade ago, high-deductible plans now cover more than four of 10 Americans, according to the U.S. Centers for Disease Control and Prevention, which defines such plans as having a $1,300 deductible for an individual and $2,600 for families.

What deductible should I choose for comprehensive? ›

How much comprehensive deductible do I need? Comprehensive deductibles can range from $100 to $2,000 in most states. The right comprehensive deductible amount for you depends on your preferences and needs for out-of-pocket costs and your overall insurance rate.

Is it better to have a cheaper deductible? ›

A lower deductible plan is a great choice if you have unique medical concerns or chronic conditions that need frequent treatment. While this plan has a higher monthly premium, if you go to the doctor often or you're at risk of a possible medical emergency, you have a more affordable deductible.

What happens when you max out your deductible? ›

A health insurance deductible is a set amount you pay for your healthcare before your insurance starts to pay. Once you max out your deductible, you pay a copayment or coinsurance for services covered by your healthcare policy, and the insurance company pays for the rest.

What is considered high deductible? ›

Per IRS guidelines in 2025, an HDHP is a health insurance plan with a deductible of at least $1,650 if you have an individual plan or a deductible of at least $3,300 if you have a family plan. The deductible is the amount you'll pay out of pocket for medical expenses before your insurance pays anything.

Does insurance cover anything before the deductible? ›

Your health insurance might not pay a dime toward anything but preventive care until you've met your deductible for the year. Before the deductible has been met, you pay for 100% of your medical bills.

Is a deductible a good thing? ›

While monthly payments may be more expensive, your deductible is lower, which means you'll pay less money before your plan starts paying. This can make your yearly costs more manageable if something unexpected happens or if you have frequent care needs.

Is it better to have a copay or deductible? ›

Deductibles are cumulative annual amounts. While copays are fixed amounts paid per service. Additionally, copays are usually a predictable fixed cost, whereas deductibles can lead to more variable out-of-pocket expenses depending on the healthcare services used.

What does a $400 deductible mean? ›

For example, imagine you have a $400 comprehensive deductible, and you file a claim for $1,000 worth of damage after a tree falls on your car. If your claim is approved, you'll pay $400 out of pocket and the insurance company will pay the remaining $600.

What are examples of deductible items? ›

If you itemize, you can deduct these expenses:
  • Bad debts.
  • Canceled debt on home.
  • Capital losses.
  • Donations to charity.
  • Gains from sale of your home.
  • Gambling losses.
  • Home mortgage interest.
  • Income, sales, real estate and personal property taxes.

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