Deductible

Deductible is the annual fixed amount that a member must pay before benefits are payable. The amount of deductible varies according to the plan options opted by a member.

Like copay, deductible is also not applicable to all services. It may be applicable only on certain services. For example, it may be applicable for a regular physician visit and not on emergency services.

Typically, each member covered under a plan has their own deductible to meet. Many policies also have family deductibles that offer a break to larger families. A family deductible can be met together instead of each person meeting their individual deductible.

 If a plan offers both coinsurance and deductible, first deductible is deducted from the billed amount. Thereafter, coinsurance is deducted from the remaining billed amount.

Exercise for deductible Question Eric falls off the roof and is taken to the hospital by ambulance. The ambulance service costs him $500. Eric is covered under a health insurance plan that has $150 deductible and 80:20 coinsurance. How much amount does Eric need to pay?