What if You Don't Meet Your Yearly Deductible in Medical Insurance? | Sapling

What if You Don't Meet Your Yearly Deductible in Medical Insurance?

Written By
Karen Farnen
Karen Farnen
Feb 10, 2011
1 minute read
Doctor talking to girl (5-7 years) in examination room
A patient and doctor. Image Credit: Michael Blann/Photodisc/Getty Images

Many health plans don't pay benefits until your medical bills reach a specified amount, called a deductible. This could be $1,000, $2,000 or even more, depending on the type of plan you choose. If you don't meet the minimum, your insurance won't pay toward expenses subject to the deductible. Nonetheless, you may get other benefits from the insurance even when you don't meet the minimum requirement.

When the Deductible Doesn't Apply

The deductible doesn't always apply to all types of medical services. Depending on the particular plan, your health insurance company may pay certain costs even before you meet the deductible. For example, many plans cover preventive services, including regular check-ups and required vaccines, with no deductible. Some plans also cover medications before you meet the deductible.

How Insurance Reduces Prices

Even if you don't meet the deductible, you can save money on services that are subject to it. Insurers typically negotiate lower prices, so you'll save half off the regular price on average compared to someone without insurance, according to the HealthCare.gov website.

For example, you may have a $1,500 deductible and receive a service normally costing $1,000. Your insurance company won't pay if you haven't met the deductible. However, if it negotiates a cost of $500, you'll save $500, even if that amount comes out of pocket.

Karen Farnen

Karen Farnen has been writing online since 2009. She has taught piano and English as a second language. Farnen has a Bachelor of Arts in French with a music minor from the University of Pittsburgh and a Master of Science in education and a…

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