How does the deductible work?

The deductible is the amount that you are responsible to pay before the insurance benefits start paying for the treatments or services.

If you choose a zero ($0) deductible, that means you are not required to pay any deductible and your benefits start immediately. If a plan pays 80% for the first $5,000, and 100% after that, this means that the insurance pays 80% for your first bills of up to $5,000.

Example : Say you pick a policy with $0 deductible that pays 80% for the first $5,000 and 100% after that. Assume there are claims of $25,000. The deductible is $0. So, you do not have to satisfy any deductible. Now, out of this $25,000 worth of claims, insurance pays 80% for the first $5,000, which is $4,000, and you would be responsible for $1,000. Any amount after that means from $5,001 to $25,000, insurance will pay 100%. So, with this particular policy, out of a total of $25,000 in claims, you pay $1,000 out-of-pocket and rest is paid by the insurance company.

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