14.3.4: Deductables
A deductible is the amount that the insured person must pay for their healthcare before the insurance “kicks in” to pay the remainder. If a person never gets sick or injured and doesn’t visit the doctor throughout the year, they won’t have to pay any more than their premiums. If they do get sick or injured, then they’ll have to pay up to the deductible amount, after which insurance pays the rest. Deductibles vary by plan, but typically have an inverse relationship with premiums. If premiums are high, deductibles tend to be lower, and if premiums are lower, deductibles tend to be high. For example, if a person breaks their arm and has a trip to the emergency room (ER), the entire visit might cost $2000. If their deductible is $3500, they would have to pay the full $2000. However, if they required surgery and a hospital stay that totaled $150,000, they would only be responsible for the $3500 deductible amount before their insurance would begin to help cover the cost. This doesn’t mean that the insurance would pay the remainder of the bill however - see coinsurance and out of pocket maximum below (Cigna Healthcare, 2023).