6 things to know about health insurance deductibles

Deductibles, premiums, copayments, and coinsurance, are important for you to consider when choosing a health insurance plan. You can compare health plans and see if you qualify for lower costs before you apply. Most people who apply will be eligible for help paying for health coverage.

Here are 6 important things to know about deductibles:

1. Having health insurance can lower your costs even when you have to pay out of pocket to meet your deductible. Insurance companies negotiate their rates with providers and you’ll pay that discounted rate. People without insurance pay, on average, twice as much for care.
2. A health insurance deductible is different from other types of deductibles. Unlike auto, renters, or homeowners insurance, where you don’t get services until you pay your deductible, many health insurance plans provide some benefits before you meet the deductible.
3. All Marketplace plans cover preventive care. Screenings, immunizations, and other preventive services are covered without requiring you to pay your deductible. Many health insurance plans also cover other benefits like doctor visits and prescription drugs even if you haven’t met your deductible.
4. In 2014, there’s a $6,350 maximum for individual out-of-pocket costs for in-network services.The maximum for families is $12,700. Even if you choose a high deductible catastrophic plan, your out-of-pocket costs should not exceed this limit.
5. Over 70% of Marketplace plans have deductibles under $3,000. When you choose a health insurance plan, it’s important to understand what your insurance company covers without requiring you to pay your deductible. Then you can decide whether you want a plan with lower monthly premiums and a higher deductible, or one with a higher monthly premium and a lower deductible.
6. Silver plans can save you more. If you qualify for lower out-of-pocket costs and choose a Silver plan, you can save more with a lower copay and a lower deductible. If you qualify, you'll get the out-of-pocket savings benefits of a Gold or Platinum plan for a Silver plan price. You can choose any category of plan, but these out-of-pocket savings apply only if you enroll in a Silver plan.

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What is an Insurance Deductible?

What is an Insurance Deductible - In an insurance policy, the insurance deductible is the amount of expenses that must be paid out of pocket before an insurer will pay any expenses. In general usage, the term deductible may be used to describe one of several types of clauses (see below) that are used by insurance companies as a threshold for policy payments.

How Does a Deductible Work? Deductibles are typically used to deter the large number of trivial claims that a consumer can be reasonably expected to bear the cost of. By restricting its coverage to events that are significant enough to incur large costs, the insurance firm expects to pay out slightly smaller amounts much less frequently, incurring much higher savings. As a result, insurance premiums are typically cheaper when they involve higher deductibles. For example, phone companies offer replacement plans, with the deductible set at the level of the wholesale price of the phone. As added benefit to them, the customer does not switch to different company as they often do with a new phone purchase.

Deductibles are normally provided as clauses in an insurance policy that dictate how much of an insurance-covered expense is borne by the policyholder. They are normally quoted as a fixed quantity and are a part of most policies covering losses to the policy holder. The insurer then becomes liable for claimable expenses that exceed this amount (subject to the maximum sum claimable indicated in the contract). Depending on the policy, the deductible may apply per covered incident, or per year. For policies where incidences are not easy to delimit (health insurance, for example), the insurance deductible is typically applied per year.

Several deductibles can be set by the insurer based on the cause of the claim. For example, a single housing insurance policy may contain multiple deductible amounts for loss or damage arising from theft, fire, natural calamities, evacuation etc. There are also insurance deductible reimbursement programs that reimburse a deductible in the event of an automobile, home, boat/yacht or health insurance claim.

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