Deductible - Glossary (2024)

FAQs

Deductible - Glossary? ›

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.

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.

A deductible is the amount you pay for out-of-pocket costs for your covered health care before your plan begins to pay. A deductible is different than a premium. A premium is the amount you pay, usually every month, to have health insurance.

Understanding what a deductible is. 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.

You have an “80/20” plan. That means your insurance company pays for 80 percent of your costs after you've met your deductible. You pay for 20 percent. Coinsurance is different and separate from any copayment. Copayment (or "copay")

There are two types of health insurance deductibles: individual and family deductibles. A health insurance plan can have either one of these or a combination of the two. The individual deductible is straightforward, but the family deductible is more complex.

A deductible is an expense that a taxpayer or business can subtract from adjusted gross income, thus reducing the amount of taxes they owe. The IRS provides lists, requirements, and amounts of all available deductibles. Taxpayers with very high deductible expenses may opt to itemize their deductibles.

Often other services, such as doctor visits or prescription drugs, are excluded from deductible requirements as well. For these services, patients must pay any required copayments or coinsurance but not the full cost of the service, even if they have not yet reached their deductible.

How is a 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.

Per Cause/Per Term Deductible

“Per term,” meaning everything you pay toward covered expenses adds up over the course of your plan's term until you meet that deductible, when the insurance company starts paying.

For example, if you have a $500 deductible on your home insurance and file a claim for $2,000 in damages, you'll pay the first $500, and your insurer covers the remaining $1,500. Choosing a higher deductible often results in lower premiums but means you'll bear more of the financial burden in the event of a claim.

What Does 100% After Deductible Mean? You might see this phrase on the paperwork relating to your health insurance, and it can be confusing. This means that you will not have to pay a co-pay after you reach your deductible, because, after that point, your insurance company will pay for all of your healthcare costs.

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 high-deductible plan is any plan that has a deductible of $1,600 or more PDF opens in new tab for individual coverage and $3,200 or more for family coverage in 2024. Compared to a traditional health insurance plan, a high-deductible health plan comes with a higher deductible and lower premium.

A $1,000 car insurance deductible means you must pay $1,000 out of pocket before your insurance company pays for the rest of a claim. In most cases, your insurance company will pay the claim amount, minus the $1,000 deductible, directly to you or a third-party like a mechanic.

A deductible is the set amount of money you pay out of pocket for covered services per plan year before your insurance starts to share costs. A copay is also a set amount of money, but it's a fixed fee attached to certain covered services. Copays don't always count towards your deductible.

Even a small percentage can add up to a significant expense. For example, let's say your home has an insured value of $300,000 and a 5% deductible for hurricanes. If it's damaged in a storm, you'd be responsible for up to $15,000 before your insurance company starts paying.

Example of coinsurance with high medical costs

You'd pay all of the first $3,000 (your deductible). You'll pay 20% of the remaining $9,000, or $1,800 (your coinsurance). So your total out-of-pocket costs would be $4,800 — your $3,000 deductible plus your $1,800 coinsurance.