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

Before the deductible, with a few exceptions such as an annual wellness visit on many plans, everything is your responsibility to pay at the rates insurance sets.

After the deductible, you’re usually responsible for some fraction of the costs (at insurance set prices) until you reach the out of pocket maximum.

After the out of pocket maximum, everything covered by insurance is paid entirely by insurance. (Up to a annual benefit limit, if the plan has one)

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