Deductible
Updated for plan year 2026
In plain terms
A deductible is the amount you pay out of pocket for covered health services each year before your insurance begins to pay its share. If your deductible is $2,000, you pay the first $2,000 of covered care yourself. After that, you and the plan split costs through coinsurance or copays until you reach your out-of-pocket maximum. Most plans cover certain preventive services, like annual checkups and recommended screenings, at no cost even before you meet the deductible. Deductibles reset at the start of each plan year.
A plain example
Say your plan has a $3,000 deductible. You break your wrist in February, and the urgent care visit, X-ray, and cast total $1,800. Because you haven't met your deductible, you pay the full $1,800. The remaining $1,200 of your deductible still stands, so the next covered service that year keeps counting toward it until you've paid $3,000.
Why it matters
A low premium often hides a high deductible, which is the real number that decides what you pay when you actually get sick. Two plans with the same monthly cost can leave you thousands apart after one hospital stay. Reading the deductible, not just the premium, is how you tell a cheap plan from one that only looks cheap.
A common point of confusion
People assume meeting the deductible means the plan now pays everything. It usually doesn't. After the deductible you still owe coinsurance or copays until you hit the separate, higher out-of-pocket maximum.