What is the downside of having a deductible?

Asked by: Mrs. Tabitha Cruickshank Jr.  |  Last update: February 24, 2026
Score: 5/5 (73 votes)

Disadvantages of Deductibles If you have a high health insurance deductible, you may hesitate to seek medical care until you've met your deductible. It can lead to delayed care, which can be harmful if you have a serious or urgent medical condition.

What are the disadvantages of a deductible?

Disadvantages of Deductibles in Health Insurance
  • The insured will be required to pay off the medical expenses, even if they do not have the resources to bear the cost. ...
  • In case of a higher deductible, the insured will be required to pay from their pocket, reducing their savings.

Is it better to have a deductible or not?

Key takeaways. Low deductibles are best when an illness or injury requires extensive medical care. High-deductible plans offer more manageable premiums and access to HSAs. HSAs offer a trio of tax benefits and can be a source of retirement income.

Why is it not a great idea to have a high deductible?

Large medical expenses: Since HDHPs generally only cover preventive care, an accident or emergency could result in very high out-of-pocket costs. Future health risks: Because of the costs, you may refrain from visiting a physician, getting treatments, or purchasing prescriptions when they're not covered by your HDHP.

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.

How Much Car Insurance Do I Actually Need?

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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.

What is too high of a deductible?

For individuals, a health plan can qualify as high deductible if the deductible is at least $1,350, and the max out-of-pocket cost (the most you'd pay in a year for medical expenses, with insurance covering everything else) is at least $6,750.

What is the main disadvantage of choosing a high deductible?

The primary disadvantages of a high-deductible health plan include the high out-of-pocket costs and the potential reluctance to seek medical care due to upfront expenses.

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).

Who benefits from a high deductible plan?

If you're generally healthy and don't have medical expenses beyond annual physicals and preventive screenings, an HDHP could save you several hundred dollars or more a year.

Do copays count towards deductible?

Copays do not count toward your deductible. This means that once you reach your deductible, you will still have copays. Your copays end only when you have reached your out-of-pocket maximum.

Is it good to have a $0 deductible?

Is a zero-deductible plan good? A zero-deductible plan is usually good health insurance with straightforward coverage. The plan's benefits will begin right away, and you won't need to pay the full cost of medical care in the beginning of the year to meet a deductible.

How can I meet my deductible quickly?

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.

What are the 3 reasons for deductibles?

There are two major reasons that deductibles are part of an insurance contract:
  • Moral hazard. Moral hazard is the behavioral risk that the policyholder will purposefully seek out insurance payouts. ...
  • Reduction of claims.

What is bad about having a high deductible?

Namely, you're responsible for paying a larger portion of your healthcare expenses out of pocket. This can be a significant financial burden for those with a lot of medical expenses and could lead to financial strain. HDHPs may not be the best choice for those with chronic or frequent medical needs.

What is the upside to having a high deductible?

This means you'll pay less each month for insurance and more out-of-pocket when you receive care. The upside? Preventive care is still covered at 100 percent on these plans. Once you hit your deductible, your health plan will start to cover the cost of your other care.

Does insurance pay 100% after deductible?

You pay the coinsurance plus any deductibles you owe. If you've paid your deductible: you pay 20% of $100, or $20. The insurance company pays the rest. If you haven't paid your deductible yet: you pay the full allowed amount, $100 (or the remaining balance until you have paid your yearly deductible, whichever is less).

What is a good deductible price?

Generally, drivers tend to have average deductibles of $500. Common deductible amounts also include $250, $1000, and $2000, according to WalletHub. You can also select separate comprehensive and collision coverage deductibles.

Is it better to have high or low deductible?

A lower deductible plan is a great choice if you have unique medical concerns or chronic conditions that need frequent treatment. While this plan has a higher monthly premium, if you go to the doctor often or you're at risk of a possible medical emergency, you have a more affordable deductible.

What is a good deductible for health insurance?

A plan that has a deductible of at least $1,400 (for individuals) or $2,800 (for a family) is considered a high-deductible plan. If your insurance plan has a low deductible, this means you may reach the threshold earlier and get cost-sharing benefits sooner.

What is considered a high deductible health plan in 2024?

For calendar year 2024, a “high deductible health plan” is defined under § 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,600 for self-only coverage or $3,200 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not ...

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.

Is $3,000 a high-deductible for health insurance?

The higher the deductible, the more out-of-pocket costs you pay before your insurer begins covering medical expenses. The IRS defines high-deductible health plans for 2023 as: Individual plans with deductibles of at least $1,500. Family plans with deductibles of at least $3,000.

What happens if you don't meet your insurance deductible?

If you do not meet the deductible in your plan, your insurance will not pay for your medical expenses—specifically those that are subject to the deductible—until this deductible is reached.