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Marketplace America.org Health Insurance

Deductible

What is Deductible in Health Insurance?

A deductible is the initial amount you’re responsible for paying toward covered healthcare services before insurance coverage takes over.

Example:

The average deductible for employer-sponsored health insurance in 2022 was $1,763. This means that you’ll cover the first $1,763 of eligible services on your own.

Once your deductible is met, typically, you only pay a copayment or coinsurance for the services that are covered. Your insurance company handles the remaining expenses.

It’s worth noting that some plans cover specific services, such as checkups or disease management programs, even before you fulfill your deductible (see plan details). Additionally, all Marketplace health plans cover the complete cost of certain preventive benefits before you reach your deductible.

In some cases, certain services like prescription drugs might have separate deductibles. Family plans often include both an individual deductible, applicable to each family member, and a family deductible, applying to the entire family.

Note:

Plans with lower monthly premiums come with higher deductibles. Oppositely, plans with higher monthly premiums tend to feature lower deductibles.

References

“Glossary.” HealthCare.gov, www.healthcare.gov/glossary/.

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