How do you reach a deductible when it comes to health insurance? Does that mean money out of pocket?

Answer 1

Sort of.

The money is definitely coming out of your pocket. But, a deductible is any amount of money spent by you that qualifies you for an insurance benefit.

So, you meet the deductible, let's say, $500 of your own money, and the carrier begins to pay 80% of any claim (medical charges) over $500 while you pick up the other 20%, for instance.

"Out of pocket" usually refers to a total amount of money required before the carrier begins to pay 100% of your claims. For example, after meeting the deductible for the 80-20% benefit described above, let's say that the policy states that your total "out of pocket" expenditure - your deductible ($500) and 20% of claims over that - for the calendar year must be $4000 before the policy will pick up any amount over that at 100%. After your 20% equals $3500, the carrier would pay any additional claims over $4000 ($500 +$3500) at 100%.

Hope that helps.

Answer 2

Yes, if you have a health insurance policy with a deductible, you will be liable for that dollar amount if/when you use medical services.

If you have a policy with a $500 deductible, you are going to pay the first $500 per year for any services to which the deductible applies. (Sometimes certain services may be exempt from the deductible - for example, office visits for which you have a fixed copay, etc. You can clarify any services to which deductible doesn't apply by reviewing your policy and/or calling your insurance company.)

Also important to remember that the claims still need to be billed to your insurance company - the insurer keeps track of your deductible based on claims that are billed to them, and will let you know what you owe the providers based on the discounted network rate with them.

Answer 3

Correct. Deductible is the amount you pay before the insurance company begins paying for certain services, such as a hospital stay.
Many services are usually covered on PPO plans without having to meet the deductible first. Examples of these services may be office visits, medication, annual physical/gynecological exams, and urgent care facilities.

Answer 4

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RE :How do you reach a deductible when it comes to health insurance? Does that mean money out of pocket?
Follow 5 answers

Answer 5

deductible means what you have to pay before the insurance company begins to fully cover you on that particular benefit. ex: if you have a $3500 deductible on health insurance, then everytime you go to the dr. until each visit reaches $3500, the insurance company wont pay 100% of your preceding visits.

Answer 6

The deductible is the amount you pay before the coverage kicks in .

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