01/06/2026
What is a deductible?
A deductible is the amount of money you must pay out-of-pocket each year before your insurance starts helping pay for most medical services.
Think of it like this:
Your insurance doesn’t start paying right away — you have to meet your deductible first.
Example
If your deductible is $3,000:
You pay the first $3,000 of your medical bills for the year.
After you’ve paid that amount, your insurance begins to share the cost.
What happens after I meet my deductible?
Once your deductible is met, you usually start paying a smaller portion of the bill, such as:
A copay (example: $40 per visit), or
Coinsurance (example: you pay 20%, insurance pays 80%)
Important things patients often don’t realize
• The deductible resets every year (usually January 1st).
• Many plans have high deductibles — often $3,000 to $8,000.
• Some services (like preventive visits) may be covered before the deductible, but labs, imaging, procedures, and medications often are not.
• Even though you have insurance, you may still owe the full visit cost until the deductible is met.
Why do I still owe money if I have insurance?
Having insurance does not mean everything is free.
It means your insurance has negotiated rates — but you are responsible for the bill until your deductible is satisfied.
How to check your deductible
Patients should contact their insurance company and ask:
“What is my deductible, and how much have I met so far this year?”
