Costs

Deductibles

What you pay before insurance coverage kicks in
tl;drYour deductible is the amount you pay for healthcare before your insurance coverage kicks in. Some basic services, like your flu shot, are covered even before you hit your deductible.

What is a deductible?

A deductible is an out-of-pocket payment toward your health care costs. After the cost of care you receive hits that amount, your insurance either covers your care completely, or splits the costs with you.

For example, if you have a $2000 deductible, you must pay $2000 before your health insurance benefits kick in. It’s essentially the amount you must pay before your health insurance carrier starts to pay benefits (with some exceptions).

Every year, your deductible resets. Some plans (like family plans) may have multiple deductibles (individual and family). Some plans with out-of-network coverage also have separate deductibles (in- and out-of-network). Once you've met your deductible, you'll still have to cover some costs like co-pays, so you deductible isn't the maximum amount of money you'll spend on healthcare that year (see out-of-pocket maximum).

Do I always have to meet a deductible before my care is covered?

Not necessarily. For one, all ACA-compliant Marketplace plans must cover the full cost of certain preventive benefits before you’ve met your deductible. These includes things like annual physicals, vaccines, and other screenings.

Some plans also offer a $0 deductible, meaning that you don’t pay any deductible before your benefits kick in. These plans often have a higher monthly premium.

Deductibles still making you delirious? Catch Support is here to help.