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Q: What Is a Deductible?

Asked by Anonymous on September 29, 2017

Erica Block September 29, 2017

A health insurance deductible is the dollar amount you have to pay out-of-pocket for covered healthcare and medical services before your health insurance coverage “kicks in” and starts to cover the cost of your care. One exception to this occurs under the Affordable Care Act, as the law requires marketplace plans to cover the full cost of preventative care, whether or not a policyholder has fulfilled his or her annual deductible.

Health Insurance Deductible Amounts Can Vary by Metal Level: Annual health insurance deductible amounts vary from one health insurance plan to another. Plans with higher metal levels (such as “gold” or “platinum” plans) tend to have lower annual deductibles and higher monthly premiums. Plans categorized under lower metal levels (like “bronze” plans) tend to have lower monthly premiums and larger annual deductibles. In other words, plans with lower premiums have higher deductibles and vice versa.

Most insurance plans have two deductible amounts: an individual deductible, which applies to individuals who are the sole policyholders covered by their plan and a family deductible, which applies when more than one person is covered under the same plan.

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