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Everything to Know About Deductible Insurance

Everything to Know About Deductible Insurance

What is Deductible Insurance?

Deductible Insurance is an insurance policy where you have to pay a certain amount of money, also known as a deductible, each year before your insurance policy becomes active.  Once it is active it takes over the remaining payments. Deductible insurance is common in the healthcare industry. After an individual paid their deductible for a given year, they usually only have to pay a copay or coinsurance for the rest of the year. The insurance policy covers the rest of your healthcare costs.

How Does Deductible Insurance Work?

Deductible Insurance requires you to pay a deductible each year before your insurance begins to cover your healthcare expenses. Most insurance policies will expect you to pay the deductible starting from January 1st of that year.

For example, if you have an insurance plan with a $1,500.00 deductible, you will have to pay that deductible before your insurance kicks in and begins paying for your healthcare expenses.

After that, you will usually only have to pay copays or coinsurance for the remainder of that calendar year.

Preventative Care is Excluded from Your Deductible:

When you are paying your deductible for the year, you will not have to pay for preventive care as part of your deductible. All Healthcare Market Plans that are offered in the US must cover specific basic healthcare requirements without charging coinsurance or co-pays or requiring you to pay for services through your deductible insurance payments.

What exactly constitutes preventative care?

The following are some items that would qualify as “preventative care” on almost all deductible insurance plans:

  • abdominal aortic aneurysm one-time screening
  • alcohol misuse screening and counseling (for those who need it)
  • aspirin use (when necessary for those 50+)
  • blood pressure screening
  • cholesterol screening
  • colorectal cancer screening (adults ages 50 to 75)
  • depression screening
  • Type 2 Diabetes screenings
  • diet counseling (for those at higher risks of chronic disease)
  • fall prevention (ages 65+)
  • Hepatitis B/C screening
  • HIV screening
  • standard immunizations (i.e. diphtheria, Hepatitis A/B, mumps, rubella, tetanus, etc.)

These basic services are provided free of charge to all who qualify. They are required to be included in every single Healthcare Market Plan that is put on the market in the US today.

Individual Versus Family Insurance Deductibles:

Depending on your policy, you will have an individual deductible if you are the only person on your deductible insurance plan. If you have a family plan (multiple people on your plan) you may be required to have an insurance deductible on each individual as well as a family limit of deductibles you will be required to pay.

Once you reach your family deductible you will not be required to pay any more deductibles for the year. Alternatively, if you reach an individual’s deductible, they will not have to pay more for the year.  But, your family plan may require the deductibles for other members of your family till their individual or the family total is met.

Most deductibles get based on the household income (how much you make versus how much you can afford to pay – a percentage of your income will go to healthcare costs).

Conclusion:

For further assistance with determining if deductible insurance is right for you, please feel free contact us via phone at 203-723-8500 so that the Branco Insurance Group can help you. We are always here to assist, and it’s your pleasure to serve you.



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