How do health insurance deductibles work?

7 Comments

1. mbrcatz17 says:

   August 28, 2009 at 12:42 pm

   Well, the deductible is how much you pay of covered services, BEFORE the insurance kicks in.

   So, you pay for the first 5-6 doctor visits, or the first couple of emergency room visits, or the first broken arm, etc, whatever adds up to $1,000, BEFORE the insurance pays one dime.

   If you don’t see the doctor often, you’ll be ahead of the game in three months.
2. bettyk says:

   August 28, 2009 at 12:42 pm

   You need to speak with an insurance councellor regarding health ins. I just went through that myself. It takes some explaining and investigation as they are not all the same. bettyk
3. John says:

   August 28, 2009 at 12:42 pm

   You pay the first $1K medical bills. Your insurance kicks in after the initial $1K, not at 100%, but based on whatever your insurance plan/contract says, usually it’s 80/20, meaning insurance picks up 80% and you pick up 20% of the bill up to your annual deductible limit. Anything after that annual deductible limit, insurance will pick up 100%.
4. adk_eric says:

   August 28, 2009 at 12:42 pm

   John’s answer is correct but also look for something called a "stop loss limit". This limit is the most you will have to pay total out-of-pocket in any given year, including the 20% coinsurance and $1K deductible.
5. Insurance says:

   August 28, 2009 at 12:42 pm

   Its easy to compute 180 x 12 = 2160 vs 480 x 12 = 5760.

   As the deductible is only 1,000 and the premium difference is 3,600. or an extra of 300 per month. Mathematically if nothing happens to you for the next 3.5 months and you already have 1,000 in your bank account to cover the dedutible.

   If you don’t fore see any claims for the next 3-4 months you should take the $180 per month plan.

   Also insurance companies will impose a 30 days waiting period and 120 days to 12 months exclusion period for pre-existing condition. Technically if you opt for $ 480 plan you may not get protection immediately. as it is normal for insurance company to impose waiting period and certain exclusions.

   Ask your agent to compare for you
6. zippythejessi says:

   August 28, 2009 at 12:42 pm

   A deductible is the amount that you have to shell out before the company picks up the tab. NEVER pay a provider up front – ALWAYS have the insurance billed first. If you use a participating provider, you’ll pay a LOT less than if you paid first. Reason is: participating providers accept a discount from the plan. The second reason you want the insurance billed first is because that’s how the deductible is tracked.

   That said, basically you want to have the least out of pocket. If you’re a healthy adult with no children, who doesn’t use the insurance often, go with the cheaper premium and the deductible – you’ll come out ahead financially. (If you don’t use the insurance, you don’t pay the deductible.) If you have any chronic condition, or young children – go with the $480 a month plan – it’ll work out cheaper in the long run.

   Good luck!
7. mzprincesslady says:

   August 28, 2009 at 12:42 pm

   If you are the type that doesn’t use your insurance as much but you are paying for health insurance every month you should go with a company called Ameriplan visit the website and look over your options. With this plan you don’t have to worry about deductilbes or co-pays.