A deductible is the amount you may have to pay for certain covered health care services before your insurance plan begins paying according to its normal cost-sharing rules.
For example, suppose your deductible is $2,000.
If you receive covered services that are subject to the deductible, you may have to pay the applicable costs until you have paid $2,000. After that, your plan may begin sharing the cost through copayments or coinsurance.
However, deductibles do not necessarily apply to every service. Some plans cover certain services before the deductible is met. For example, Marketplace plans in the U.S. cover certain preventive services without cost-sharing when applicable requirements are met.
Simple example
Suppose:
- Your deductible = $2,000
- A covered medical service costs $500
- The service is subject to your deductible
You may pay the $500 rather than having the insurance company pay the full amount.
If you later have another $1,500 in applicable covered expenses, you may reach your $2,000 deductible.
The exact amount you owe depends on the plan’s rules, negotiated rates, network status, and the service received.
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