Medical Deductibles
Take Advantage of Your Benefits, Consider Planned Care Now.
If you've met or are close to meeting your health insurance deductible, now may be a great time to schedule the care you've been delaying. Your out-of-pocket costs may be lower before the end of your plan year, depending on your coverage.
Whether you need an orthopedic procedure, heart health screening or hernia repair surgery, don't wait until the holiday rush. Schedule your appointment now to make the most of your benefits and secure a convenient appointment time. Coverage and costs vary by plan, so be sure to check with your insurer.
What Is a Medical Insurance Deductible?
Your deductible typically applies during a specific plan year. Once you meet it, you may still pay a copayment or coinsurance for covered services. Your monthly premium keeps your insurance active. Your deductible applies when you receive covered care. Costs may also vary based on whether:
Your deductible applies to covered services until you reach the amount set by your plan. For example, with a $2,000 deductible, you may pay the first $2,000 of eligible covered services.
Some preventive services may be covered before you meet your deductible, depending on your plan. Your insurance may also include separate deductibles for prescription drugs, family members or certain types of care.
- An orthopedic procedure or joint replacement
- A heart health screening or cardiology procedure
- Hernia repair surgery
- Gallbladder surgery
- Another medically recommended elective procedure
How Do You Meet Your Medical Insurance Deductible?
Eligible covered services count toward your deductible according to your plan. To review your progress, review your insurance plan or member portal.
Does Elective Surgery Count Toward Your Deductible?
Elective surgery may count toward your deductible when it is covered by your insurance plan. Coverage may depend on medical necessity, prior authorization, the procedure, the facility and your plan’s network requirements.
Planned procedures may include hernia repairs, gallbladder surgery, joint replacement and other general surgery procedures. Cosmetic or non-covered procedures generally may not apply to your deductible. Confirm your benefits before scheduling.
Do You Pay Medical Deductibles for Outpatient Treatment?
You may pay toward your deductible for covered outpatient treatment, depending on your plan. Outpatient care may include physician visits, imaging, diagnostic testing and same-day surgery. Outpatient treatment may involve separate charges from the physician, facility, anesthesia, imaging or laboratory providers. Ask which providers are involved and whether they participate in your insurance network.
Frequently Asked Questions
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