How Much Deductible Must I Pay?
A deductible is an amount you pay before the Insurance Company starts paying. Health insurance plans will have different deductibles. Low deductible examples might be a “Gold” plan, with example deductibles of $500, $1,000, $2000, etc. An example of a “Silver” plan might have a higher deductible such as $4,000, $5,000, etc. A higher deductible would be seen in a “Bronze” plan at a deductible of about $8,700. But still, what is a deductible?
You Must Pay Your Deductible First
Think of it like getting to 1st base in a game of baseball. You start on home plate, and when you get your first medical bill, you’d start running towards 1st base. Beginning to pay towards meeting your deductible. You’ll be expected to pay the whole medical bill out of your own pocket until you’ve paid your deductible, or in other words, reaching 1st base using our analogy.
The very good news is, no matter what the deductible is, you will most likely pay what the insurance company has “negotiated” with the doctor or hospital, even before you’ve paid off your full deductible. As an example, if you have a $1,000 doctor bill because you visited a dermatologist for burning off a wart, the insurance company may have a negotiated a price of about $300 with that doctor, instead of having to pay the full $1000. That $300 you pay will apply to your deductible. So, if you have a $4000 deductible, now you’d have $3700 left of your deductible. Make sense?
Once you’ve paid all your deductible, you are standing on 1st base, using our baseball analogy. Until you’ve paid all $4000 using our deductible example, you’ve not reached 1st base yet. But once you’ve come out of pocket the full $4000, now you’ll begin to move towards 2nd base – “Co-Insurance”. During this time, co-insurance is where you and the insurance company split the medical bills. Some examples, 70/30, 80/20 or 60/40. Make sure to look at your health plan to see what your deductible and co-insurance are.
So, using our $4000 deductible scenario, and dermatology bill, if you have already paid the $4000 earlier in the year, and you are standing on 1st base and now heading for 2nd base, now you’ll pay a split with the insurance company. If your co-insurance was 30%, you’ll pay using our example of $300 (negotiated price of the $1000), you’d pay 30% of $300 which is $90. So, heading to 2nd base, called “co-insurance”, you’ll pay a split of an already discounted price. Usually, the insurance company will pay the larger amount (70%) and you’d pay the lesser amount.
Your next step is 3rd base or your “Out of Pocket Maximum”. This is the maximum YOU have to pay in a year, not the insurance company. Once you’ve paid the “out of pocket maximum”, there will be no additional charges, including cost of medications. The insurance company will pick you up on 3rd base and carry you to home plate. You are all done paying for the year. Please check the details of your plan for deductible, co-insurance and out of pocket maximum.
Getting Help with Nevada Insurance Enrollment
It is hard to budget for health expenses when you do not know what your cost-sharing responsibility will be. At Nevada Insurance Enrollment, our health insurance agents can help you review your policy or find reliable health coverage.
Recent Posts
Understanding Motorcycle Insurance
If you ride a motorcycle, then you need an insurance policy that protects you and your investment. Understanding what coverage is available and even more importantly, what coverage is legally mandated, can ensure that you enjoy your bike for years to come.
Buying a Used Car From a Private Seller
The vehicle’s history report includes information such as its previous owners, open recalls and damage, accidents, repairs, maintenance history, and odometer readings. If you are buying the vehicle from a dealership, then they will probably provide you with the report if you ask for it.
How To Surrender Your Vehicles License Plates
Every state has its own laws for what you should do with your license plates if you sell your vehicle or cancel your auto insurance policy. In some states, you are allowed to keep personalized and vanity plates, but you must turn in regular license plates.
Search This Website
Most Popular Pages
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog
#5) Request a Quote
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
Top Affordable Health Insurance Options in Nevada For 2021
When choosing the best health insurance coverage, it is important to consider your expected medical expenses. Depending on your income and the plan you choose, you may qualify for premium tax credits and cost-sharing reductions, making robust health insurance coverage even more affordable.
How To Find Auto Insurance After A DUI Charge
Risky behavior, such as driving under the influence of drugs or alcohol, is a big red flag to auto insurance companies and usually results in a significantly higher monthly premium. While your auto insurance company cannot drop you as a customer after you receive a DUI, they can decide to not renew your policy after your term is up.
Does Auto Insurance Cover Riots?
No one wants to be victims of property damage resulting from rioting, and fortunately, auto insurance companies already have provisions for this risk in their coverage options. In fact, there is no need to purchase separate riot, vandalism and civil commotion coverage; if you have comprehensive auto insurance, you most likely have this coverage.
Various Tips to Protect and Maintain Your Car
According to Live Science, after being parked in the sun on a 95-degree day for an hour, the inside of a car hits an average of 116 degrees. The dashboard gets even hotter at 157 degrees, the surface of the steering wheel reaches an average of 127 degrees and the seats are a searing 123 degrees on average.