What Is a Health Insurance Deductible?

What Is a Deductible?

Most health insurance policies do not cover all the costs of care. Many ask you to pay a portion before your benefits kick in. One exception is preventive care. Most insurers will pay fully for preventive care before you meet your deductible.

Plans with lower premiums (aka monthly fees) often have higher deductibles, while plans with higher premiums usually offer lower deductibles.

In-Network Versus Out-Of-Network Deductibles

Providers that are in your insurer's network have agreed with the insurer on prices the insurer will pay for your healthcare services. Out-of-network providers have not agreed to this and can charge higher fees. Thus, going to an in-network provider will usually cost you less. Your deductible may also be lower for in-network care.

For example, your in-network deductible may be $1,000, but your out-of-network deductible might be $2,000. Furthermore, your health insurance company may not count the total cost of your visit to an out-of-network provider toward your deductible. Instead, the company may only count the amount it decides the care is worth (the “allowed amount"). For example, if your care costs $500 and the allowed amount for that type of care is $300, then only $300 will count toward your deductible.

To find out which providers are in your insurer's network, check your health insurance company's website. You can double-check with the administrator at your doctor's office as well.

Should I Get a Health Insurance Policy With Separate Deductibles?

If you are comfortable seeing the doctors in your network, you may not mind a health insurance policy with separate in- and out-of-network deductibles.

But you may have a doctor you already trust who isn't in-network, or you may have a medical condition that requires specialized care only available outside of your network. Perhaps you travel often and leave the area where your in-network doctors are. In cases such as these, you may want to get a policy with a combined deductible.

Preparing for Future Healthcare Costs Is Key

Knowing deductibles and their ripple effect on your finances can help you make stronger choices around your healthcare. Regardless of which health insurance plan you choose, take the time to examine how much you can expect to pay in different healthcare scenarios. This can help you make the choice that works best for you.

Managing Healthcare Costs with CareCredit

If you are looking for an option to help manage your medical bills, consider healthcare financing with the CareCredit credit card. The CareCredit card can help you pay for the care you want and need and make payments easy to manage.* Apply today and use our Acceptance Locator to find a provider near you that accepts CareCredit. Continue your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go, and easily access the Well U hub for more great articles, podcasts, and videos.

Our Expert Reviewer

Patty Caballero and her team of consultants together have more than 35 years of health insurance knowledge working for some of the biggest health insurance companies in the US. She has knowledge in building brands and strategic initiatives to help consumers better understand their health benefits.