Not sure how your health plan works, what your benefits mean, or how to make them work for you? You’re not alone. But we’re here to help! We’re breaking down what you need to know while there are still plenty of days left on the calendar to take advantage of some significantly reduced healthcare costs.
What is a deductible?
A deductible is the amount you spend out of pocket for medical expenses before your insurance kicks in to pay.
These days, many people are on high deductible health plans, meaning their deductible is more than $1,400 for individuals or $2,800 for families. If you’re on a plan with a $2,800 deductible and have spent more than that dollar amount on medical care this year, you’ve “met” your deductible and your insurance should now be lightening the load and helping you cover those expenses.
Got it. Once I’ve met my deductible, how much should my insurance cover?
It varies by plan. For some, meeting your deductible means your insurance covers the lion’s share, but you’re still responsible for a portion, or coinsurance. Let’s say your plan’s deductible is $2,800 and you have 20% co-insurance. Once your deductible has been met, your insurance will now cover 80% of your costs and you are responsible for the remaining 20%.
Alternately, some plans have copays, or a fixed amount paid for medical services. The copay amount may vary by type of service, but if you have a $20 copay on a doctor’s visit and the bill is $100, you will pay $20, and your insurance company will cover the remaining $80.
Not quite sure what the specifics of your plan are? You should be able to log into your insurance provider’s website or call the number on the back of your insurance card to get the specifics on your deductible, coinsurance, or copay.