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All You Need to Know About Deductibles in Health Insurance


You have opted for a health insurance policy, you are paying your monthly premiums, but when you have a need for treatment, your health insurance expects you to pay a part of the total cost. Don’t be caught unawares, there is something you need to know about deductibles in health insurance.

A deductible is the amount up to which the policyholder is expected to pay for availing healthcare services before the insurance company steps in and begins to pay/cover. Only once the deductible is met does the insurance company pay for the policyholder’s treatment or care. In other words, this is similar to self-insuring yourself before you start to claim from your insurance company. Usually, policies with lower premiums will have higher deductibles and vice versa.

The following are the different types of deductibles:

Comprehensive Deductible

The comprehensive deductible is the deductible that is applied across all types of treatment costs and other healthcare-related expenses that will be covered under the policy. It adds up until you have met the maximum deductible for the given period.

Non-Comprehensive Deductible

The non-comprehensive deductible is a deductible that only applies to specific costs towards certain medical treatments in a health insurance policy. This means that, for some treatments, there will be no deductible and for some others, the deductible will apply.

Cumulative Deductible

If members of a family are covered under a single family health insurance policy, then a cumulative deductible or a family deductible may apply. This means that a single deductible applies for all members of the family cumulatively. However, it is important to note that some family insurances may have individual deductibles as well.

Once you have met your deductibles, you think you need to make no more additional payments to the health insurance company? Well, that is where you would be wrong.

Typically, there are three types of “out-of-pocket expenses” a policyholder will incur in addition to the monthly premiums paid towards a health insurance. These are what limit the liability of the insurance company to a certain extent. The maximum amount paid cumulatively through all the three make up the “out-of-pocket maximum”. Different health insurance policies have different amounts predefined as the “out-of-pocket maximum”.

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