A health insurance deductible is the amount you pay out-of-pocket for covered health services before your insurance begins paying. For example, with a $2,000 deductible, you pay the first $2,000 of covered costs each year before your plan kicks in (except for preventive services, which ACA plans cover at no cost regardless).
A health insurance deductible is the dollar amount you must pay each plan year for covered medical services before your health plan starts sharing costs. If your deductible is $2,000 and you have a $3,000 hospital bill, you pay the first $2,000 — your insurer then covers the remaining $1,000 (minus any coinsurance). The HealthCare.gov glossary defines this term and explains how it interacts with other cost-sharing features.
Most covered services count toward your deductible: doctor visits (in some plans), specialist visits, hospital stays, lab tests, imaging, and prescription drugs. Important exceptions: ACA-required preventive services (annual physicals, screenings, vaccines) must be covered at no cost even before the deductible is met. Some plans also have separate deductibles for specific services — for example, a separate prescription drug deductible.
Family plans have both an individual deductible (each person's threshold) and a family deductible (the aggregate). Once a family member meets the individual deductible, insurance starts covering their costs. Once the family aggregate is met, insurance covers all family members regardless of individual deductibles.
Plans with lower monthly premiums typically have higher deductibles (Bronze and Silver ACA tiers). Plans with higher premiums typically have lower deductibles (Gold and Platinum tiers). If you use many medical services, a lower-deductible plan often saves money overall. If you are healthy and use few services, a higher-deductible plan with a lower premium may cost less for the year.
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