Deductible
Amount the insured must pay out-of-pocket per claim before insurance coverage begins.
FAQs
How does a health insurance deductible work alongside copayments and coinsurance?
In a typical health plan, cost-sharing has multiple layers: first, you pay the full allowed cost of services until your deductible is met ($2,000 in this example). Once your deductible is satisfied, you enter the coinsurance phase—you pay a percentage of costs (e.g., 20%) while the insurer pays the remainder (80%), up to your out-of-pocket maximum. Copayments (fixed amounts per visit or prescription) may apply either before or after the deductible depending on the plan design—many plans charge copays for primary care visits and prescriptions regardless of deductible status, while specialist visits and hospitalizations are subject to the deductible first. Once total out-of-pocket spending (deductible + coinsurance + copays) reaches the out-of-pocket maximum, the insurer covers 100% of remaining covered costs for the year.
What is a combined deductible versus separate deductibles?
A combined deductible (or family deductible) requires all family members' medical expenses to aggregate toward a single deductible threshold before any family member receives coverage. Once the combined deductible is met by the family's collective expenses, the insurer pays for all family members. Separate deductibles apply individually to each family member—each member must satisfy their own deductible before the insurer pays for that person's care, with a family limit typically (embedded deductible structure). Embedded deductibles protect family members with high individual expenses from being uncovered while waiting for the full family deductible to aggregate.
Why do businesses choose high deductibles for commercial insurance?
Businesses choose high deductibles to reduce insurance premiums, improve cash flow predictability (known out-of-pocket cost for retained losses vs. unpredictable premium increases after claims), retain tax advantages of self-funding small losses (premiums to commercial insurers aren't fully deductible immediately for some structures), and avoid premium increases for frequency losses. Sophisticated risk managers use actuarial analysis to calculate the optimal deductible: the point where premium savings from higher deductibles exceed the expected additional retained losses. Large deductible programs (LDPs) allow companies to retain significant risk while getting claims servicing and severity protection from insurers, often with collateral requirements (letters of credit) ensuring the company can fund retained losses.
Related Terms
Premium
Regular payment made by a policyholder to maintain insurance coverage.
Copayment
Fixed amount the insured pays for a covered health care service at the time of service.
Coinsurance
Percentage of costs the insured shares with the insurer after the deductible is met.
Out-of-Pocket Maximum
Annual cap on total cost-sharing required of an insured under a health plan.