4 Things Google Never Told You About Your Deductible

Posted September 8, 2016 Insurance 101

Though it might have, if you’d asked.

Your deductible is the set dollar amount you have to spend on certain health care services before insurance covers them.

1. A low deductible doesn’t always mean you’re paying less for health care.

Typically, the lower your deductible is, the higher your monthly premium will be. A low deductible plan is a good option if you use your plan a lot because it costs less to see your doctor or get prescriptions at the pharmacy.

If you don’t use health care often, take a look at high deductible plans. While individual services cost more, you’ll save on monthly bills since these plans generally have lower premiums.

2. No matter when you bought your plan, your plan renewal date will reset your deductible.

The renewal date, or when your health plan extends (usually on Jan. 1), resets the amount of money you paid into your deductible during the previous plan year back to $0.

Until you meet your deductible for the year, you may need to pay 100% of the costs for all health services except covered preventive services like vaccinations.

3. You still pay coinsurance, a smaller percentage of the total cost, after you meet your deductible.

Let’s say you need a surgery and you have a policy with a $2,000 deductible and 20% coinsurance.
The surgery costs $7,000, but your insurance will negotiate with the hospital to get a lower rate. Now the procedure has $5,000 price tag— but you don’t have to pay all of it.

You’re responsible for the first $2,000 of the total cost, which will satisfy your deductible. Now you only pay 20% ($500) of the remaining $3,000.

Just like that (okay, maybe it takes a little longer), your bill has gone from $7,000 to $2,500.

4. Can your insurance company keep charging you 20% coinsurance on every health care service you use for the rest of the year?

The short answer is “maybe.” The long answer concerns your out-of-pocket maximum, which can have an even bigger impact on you than your deductible or premium.

If you end up needing services like major surgeries or specialty drugs, your biggest concern won’t be your deductible or coinsurance— it’ll be the numbers on all those medical bills you’ve racked up.

Your out-of-pocket max puts a hard stop on how much of those bills that you have to pay.

Have questions? Contact us!

Next week, we’ll examine Copays!