A deductible is the amount of money a patient must pay out of pocket for covered healthcare services before their insurance plan starts paying. If your plan has a $1,500 deductible, you pay the first $1,500 of covered services each year. After that, the plan begins covering costs (usually with coinsurance or copays for the remaining share).
Deductibles reset annually, typically on January 1 for calendar-year plans.
You’ll hear this when…
Deductibles come up in every conversation about health plan selection and medical bills. “Have you met your deductible?” is a common question — it determines whether a patient is still paying full price or whether insurance has kicked in.
High-deductible health plans (HDHPs) have become increasingly common, especially when paired with Health Savings Accounts (HSAs). These plans have lower monthly premiums but require patients to pay more before coverage begins — often $1,500–$3,000 for an individual.
What counts toward the deductible
Not all costs count. Preventive services (annual physicals, screenings, immunisations) are typically covered at 100% by the plan regardless of whether the deductible has been met. This is an Affordable Care Act requirement for most plans. Out-of-network services may have a separate, higher deductible.
Source: Healthcare.gov — official US health insurance marketplace glossary