eli5 employee benefits deductible

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i am simply not understanding what exactly a deductible is does that mean
if my deductible is 3,000 and i use to it to go to therapy i have to pay 3,000 in therapy sessions before they start to cover it or like how does it work?
(i’m 25 and don’t rlly have parents to explain it to me and google is just confusing me)

In: Economics

4 Answers

Anonymous 0 Comments

Generally you are correct the deductible is the amount you have to pay out of pocket before insurance kicks in. In theory this is to keep you from using insurance for little things and as a way to reduce premiums.

Anonymous 0 Comments

Yes, that’s how a deductible works. There may also be other important details to be aware of, so you should read your policy carefully.

For instance, you might have a 3k deductible with 20% coinsurance and a 10k out of pocket max. In this case, you’d pay the first 3k yourself, then the insurance would pay 80% and you’d pay 20% until you had paid another 7k yourself, at which point the insurance would cover 100% of the remaining cost.

Anonymous 0 Comments

It kind of depends on how it’s defined, but usually yes. Your deductible is an amount of money that represents the maximum you’re responsible for and after that the insurance provides much more coverage.

Usually policies have one main deductible and anything you pay for out of pocket goes towards that. Sometimes there are funkier terms and conditions that apply. Like, I bet even if I meet my deductible my insurance still won’t start covering my prescription medications differently, and some specific specialist procedures probably still don’t fall under it. Nothing’s ever “standard” in these kinds of deals.

It’s one way the plan can negotiate price. Generally to get a low deductible you have to pay more, because it’s more likely you’ll meet a low deductible. Some plans are “cheap” because they have a very high deductible, but that can mean you owe a lot more if you have a big procedure done.

In a lot of ways, deductibles make buying health insurance a bit like gambling.

Anonymous 0 Comments

make sure your health plan covers therapists. And typically insurance will cover some amount even before you hit your deductible