What is the deductible policy?

Asked by: Zora Schmidt III  |  Last update: February 24, 2026
Score: 4.4/5 (8 votes)

Simply put, a deductible is the amount of money that the insured person must pay before their insurance policy starts paying for covered expenses.

Is it better to have a $500 deductible or $1000?

Generally speaking, yes, a higher deductible is the better choice long term. Especially if you have a good driving history.

What does a $1500 deductible mean?

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. After you pay your deductible, you usually pay only a. copayment.

What does it mean to have a $4000 deductible?

Let's say your deductible is $4,000. That means you'll need to pay for covered services, like doctor visits and prescriptions, out of pocket until your total payments reach $4,000. Once you've met your deductible (meaning you've paid that $4,000), your insurance kicks in.

Do you get money back from a deductible?

Yes. The insurance company will refund the amount you overpaid. Generally, once you have met your deductible then it goes to a split between you and the insurance company. So say your split is 80/20. You pay 20% of the bill until you reach your max out of pocket. Then you pay nothing for the rest of the year.

BREAKING: Senate Approves Historic OAS Bill – Big Benefit Increases Next Week!

24 related questions found

What are the disadvantages of a deductible?

The downsides of a high deductible health plan are:
  • Expensive. The upfront costs can be costly.
  • High Payments. With a high-deductible health plan, your out-of-pocket costs may be higher. ...
  • Avoiding Care. Those high payments for medical care might keep you away from checkups and other preventative measures.

Do I get my deductible back if I'm not at fault?

Yes, if you have to pay your deductible and you were not at fault, you may be able to get it back from the at-fault driver's insurance company. This is called subrogation. Your insurance company will pursue the at-fault driver's insurance company to recover the money paid for the damages, including your deductible.

Is it better to have a copay or deductible?

Deductibles are cumulative annual amounts. While copays are fixed amounts paid per service. Additionally, copays are usually a predictable fixed cost, whereas deductibles can lead to more variable out-of-pocket expenses depending on the healthcare services used.

What is the quickest way to meet your deductible?

How to Meet Your Deductible
  1. Order a 90-day supply of your prescription medicine. Spend a bit of extra money now to meet your deductible and ensure you have enough medication to start the new year off right.
  2. See an out-of-network doctor. ...
  3. Pursue alternative treatment. ...
  4. Get your eyes examined.

How high is too high-deductible?

In 2023, health insurance plans with deductibles over $1,500 for an individual and $3,000 for a family are considered high-deductible plans.

What happens if I don't meet my deductible?

(For example, if your deductible is $1,000, your plan won't pay anything until you've met your $1,000 deductible for covered health care services subject to the deductible.)

Do I pay my deductible to the Body Shop?

You typically pay your car insurance deductible after your car is fixed. Depending on your insurer and the situation, your insurer may pay the repair shop directly, minus your deductible — if that's the case, you'll need to pay the repair shop your deductible.

Do prescriptions count towards the deductible?

Your health plan generally will treat the drug as covered and charge you the copayment that applies to the most expensive drugs already covered on the plan (for example, a non-preferred brand drug). Any amount you pay for the drug generally will count toward your deductible and/or maximum out-of-pocket limits.

What is a disadvantage of having a high deductible?

Cons of High Deductible Healthcare Plans

Individuals who are stretched thin for funds may delay or avoid seeking medical treatment due to the high cost of treatment. For example, someone injured may avoid the emergency room if they know it will result in an expensive bill that will be applied to the plan deductible.

How to get deductible waived?

Fault determination: Most insurers require you to be not at fault for the accident. Some auto companies may require you to be 100 percent fault-free to have the deductible waived, while others may waive a percent of your deductible based on your percentage of fault.

Can the color of your car affect your insurance premium?

The color of your car doesn't affect your insurance rate. Instead, your insurance company uses other information, like your car's age, location, usage, and your driving record, to help determine insurance rates. Learn more about the factors that impact auto insurance pricing.

Do you pay 100% before deductible?

Let's say your plan's deductible is $2,600. That means for most services, you'll pay 100 percent of your medical and pharmacy bills until the amount you pay reaches $2,600.

Is it cheaper to have health insurance or pay out-of-pocket?

Insurance companies negotiate discounts with health care providers, and as a plan member you'll pay that discounted rate. People without insurance pay, on average, twice as much for care.

What if I can't afford my health insurance deductible?

Your healthcare provider can't waive or discount your deductible because that would violate the rules of your health plan. But they may be willing to allow you to pay the deductible you owe over time. Be honest and explain your situation upfront to your healthcare provider or hospital billing department.

Do you still pay copays if you meet your deductible?

Claims that count toward a person's deductible also count toward the family deductible. Once a person meets their deductible, they pay coinsurance and copays, which don't count toward the family deductible.

Why do I still owe money after a copay?

Non-Covered Services: Some medical services or prescription medications may not be covered by your insurance plan. If this is the case, you will be responsible for the full cost of the service or medication, which may exceed your copayment.

What is a normal deductible for health insurance?

What is a typical deductible? Deductibles can vary significantly from plan to plan. According to a KFF analysis, the 2024 average deductible for individual, employer-provided coverage was $1,787 ($2,575 at small companies vs. $1,538 at large companies).

Why do I pay deductible if I got hit?

The purpose of the deductible is to share financial responsibility between the insured and the insurance company. It also discourages filing small or frivolous claims. You may have to pay your deductible if someone hits you—even if you're not at fault.

What does subrogation mean?

When you file a claim, your insurer can try to recover costs from the person responsible for your injury or property damage. This is known as subrogation. For example: Your insurance company pays your doctor for your treatment following an auto accident that someone else caused.

Does a deductible have to be paid upfront?

But in general, network contracts between insurers and medical providers will prohibit the medical providers from requiring payment of deductibles before medical services are provided. They can certainly ask for it, and patients have the option to pay some or all of their deductible upfront.