Deductible

A health insurance deductible is the amount of medical expenses that you must pay for before your insurance company contributes toward your claims.

Health insurance deductibles are cumulative over the calendar year.


EXAMPLE
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Your plan has a $1,000 deductible. You have the following expenses:

January - $500 hospital

February - $500 hospital

November - $700 hospital

Insurance starts paying toward your November claim because you reached your $1,000 deductible in February.

Exposure is limited by your maximum out of pocket

Each health insurance policy has a maximum out of pocket amount. Your total out of pocket costs from deductibles, co-insurance and co-pays will never rise above this amount.

Is a lower deductible plan always better?

A lot of people think that the lower the deductible, the better. This does however not always apply. Because: the lower the deductible in a plan, the higher the insurance premium.

Choosing a deductible that is good for you depends on several factors such as your income, risk tolerance, your anticipated claim level and most importantly, it  requires a comparison of the premium costs between several plans with different deductibles.


Take two plans into consideration:

A) Annual Deductible $500 Annual Premium $4800
B) Annual Deductible $2000 Annual Premium $2400

Plan A has a $1500 lower deductible than plan B, however you pay $2400 more towards your premium on an annual basis. Remember your premium is the only health care cost that you have to pay even if you don’t use your insurance and don’t have any medical claims.

It is always a good practice to choose a plan with a higher deductible and a lower premium. Invest the difference in premium in a health savings account to protect a pool of money to pay for doctors visits.

 
 



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