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Health Insurance Deductibles

The deductible on your health insurance plan is the amount you will personally have to pay towards care before your insurance company begins to contribute towards any costs associated with health care services. For example, if you have a plan with a $2,000 deductible, you will be completely responsible for the first $2,000 in medical care after which your carrier will begin sharing the costs of healthcare services. Deductibles are the primary means by which insurance providers help maintain lower premiums.

Unlike deductibles in other forms of insurance which work on a per incident level, deductibles for health insurance are applied on an annual basis and generally across all services with a few exceptions. The affordable care act also establishes a maximum deductible amount which is revised each year by Human Health Services. In 2015, the maximum deductible for an individual policy was $6,600 and $13,200 for a family. 

Choosing a Deductible Level

A higher deductible reduces the total costs that insurance companies are responsible for by shifting these costs to the consumer. As a result higher deductible plans will generally have lower premiums. Until these deductibles are met you are effectively not receiving any of the cost sharing benefits of having coverage. Understanding this tradeoff is vital in how you choose a plan. The deductible structure of a health insurance plan is important in deciding which plan you choose since it dictates when the carrier begins to actually pay. 

The two primary considerations when selecting a deductible are your ability to withstand risk and the amount you expect to spend annually on healthcare coverage. If you have non-trivial and recurring healthcare expenses choosing a deductible lower than the amount you spend is generally a good choice. This guarantees that you will meet the requirements necessary for the insurance company to provide benefits. The greater your costs exceed the deductible the greater proportion of the costs will be borne by the insurer. In such cases the added benefits will usually mean more than the additional cost in premiums.

For those people with low expected healthcare expenses, a cheaper plan with a higher deductible can make more sense. This lowers your guaranteed out of pocket costs by reducing the premiums you pay on a monthly basis. The only thing to consider is when selecting a plan is