Eli5: How does American health insurance work?

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What does a deductible mean and why do you still have to spend money when you go to a doctor if you pay for insurance every month?

What are the other fancy words I need to know?

How do you know if something is a good deal?

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18 Answers

Anonymous 0 Comments

So a deductible is the amount you have to pay before insurance kicks in. It refreshes every year. Premium is how much you pay per month. Let’s say you have a deductible of 1000$. You go to the hospital for stitches. It costs 350$. That means you pay out of pocket all 350, because you haven’t hit your deductible yet. You have 650 left.

If then you go in for appendicitis and it costs another 5000, you pay 650 and that’s it. Now all things for the rest of the year are covered.

Some stuff you don’t need to pay for, Regardless of deductible, depending on insurance but that’s a lot more technical.

Jan 1 or whatever the date is, you got a new deductible of 1000$.

A copay is either a percentage or a flat rate. It basically says “for every trip to the hospital we pay for, you pay for 200$ of it too” or “you pay for 10% we pay for 90%” or some variation

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