What does it mean that health insurance pays a certain percentage after a deductible?
In most insurance plans, you have a deductible you are required to pay, like $500, then after that, you pay a certain percentage of the remaining medical expenses, such as 20%. If my medical deductible is $500, then I must pay the first $500 dollars of medical expenses before my insurance will start paying 80% of expenses past that, while I pay 20%. Look at this example:
My son breaks his arm, and the entire cost from doctor visits to cast is $800. I pay my $500 deductible, and then $300 is left. Of that remaining $300, I will pay 20%, ($60) while the insurance company pays 80%($240.)
Keep in mind that your deductible starts over every calendar year. Once you have paid it, you only have to pay 20% for the rest of the year. Some exclusions could apply to certain conditions/ charges like prescriptions, pregnancy, etc. Also remember that the higher your deductible is, the lower your health insurance is. Decide how much you use your insurance and choose accordingly.
- What is the difference between an annual deductible and an annual out-of-pocket maximum on health insurance?
- When does a health care deductible start over?
- How does the deductible work on a health insurance plan?
- Who pays for my car’s damage when the insurance only pays the deductible?
- What is the difference between a coinsurance and a deductible?