What is a Health Medical Plan Deductible?



A deductible is a specific dollar amount that your health insurance company requires that you pay out of your pocket each year before the health insurance company begins to make payments for claims. As an exception, not all health medical plans have a deductible such as an HMO or a zero dollar deductible plan. However, most PPO and Indemnity plans typically do require a deductible in their plans to keep premiums affordable.

The deductible is an annual amount per insured person; there will be a maximum amount of deductibles you will have to pay in a given year. In regards to family coverage in health medical plans, your family will have an out of pocket expense by an amount of two to three times your individual deductible to satisfy first before the health insurance company pays for your claims.

For example, if the per person deductible is $1000, and you have four people in your family covered under your health insurance, the maximum family deductible will usually be $3000. Once the people in your family have paid out a $3000 deductible, no more deductibles will apply to any member of the family for the remainder of the year.

The insurance company does have a maximum of per person deductibles per policy. This can very with each policy and company is different regarding their maximum deductible and out of pocket maximum. In some health medical plans the deductible does apply to the maximum of pocket, and in other polices it is consider separate from the annual maximum out of pocket. Please be sure to read the specifics of your policy with your health medical plans company.

Health insurance deductibles can vary and will be effect your insurance premiums. By adjusting your health medical plan deductible you premiums will either increase or decrease. Typically if you increase your deductible you will lower your premium. New High Deductible Health Plans can save you and your family premium dollars over time.

The federal government regulates the detail High Deductible Health Plans limits each year. In the year 2008, the minimum deductible amount for a High Deductible Health Plan is $1,100 for individual only coverage and $2,200 for family coverage. In addition, the maximum out-of-pocket amount for individual only coverage is $5,600 and $11,200 for families. A high deductible health plan typically offers a higher deductible in return for generally lower premiums. For more detail, please contact your health medical plans broker.




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