Why Health Insurance Plans Typically Require That Policyholders Pay Deductibles

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Why Health Insurance Plans Typically Require That Policyholders Pay Deductibles

16 December 2022
 Categories: , Blog

A deductible is a payment that a policymaker must make when they are taking advantage of an auto insurance policy. It is considered to be a form of cost-sharing. It is not the same as a premium because the premium must be paid regardless of whether the customer uses their insurance.


The premium pays for the health insurance plan and is how the health insurance provider turns a profit. Insurance policies that cover more medical treatments tend to have higher premiums. However, premiums can be reduced by bundling several policies together such as vision and dental.

Multiple Deductibles

Depending on the health insurance policy, there might be multiple deductibles that the policyholder will need to pay. For example, you might have both an individual and a family deductible limit. You might also have separate deductibles for special medical benefits and prescription drug benefits. Once the deductible has been paid, there will be no further payment unless the policyholder switches to a different insurance provider.

Fortunately, it's relatively easy to determine what a deductible is and the consumer has control over what their deductible will be. For example, a policyholder can choose to pay a lower premium in exchange for a higher deductible. This is ideal for consumers who have saved enough money to be able to pay for a higher deductible. Copay and coinsurance also affect how high the deductible will be. 

Copays and Coinsurance

The copay is the percentage that the customer will pay for a medical service. For example, they may be required to pay a copay to receive a medical checkup. Coinsurance, on the other hand, is the customer's share of the health care service they will receive.

For example, a patient might be expected to pay a quarter of the cost of their medical bill and the insurance provider will pay the rest as long as the medical treatment is covered.

How Consumers Can Choose the Right Insurance Policy

A high deductible might be shocking to a consumer, but it can be ideal for those who have saved up enough money to cover the deductible. They will be able to keep their monthly bill slow with a lower premium and the insurance provider won't have to pay for the full cost of the medical treatment. 

One of the best ways to help consumers find health insurance is an insurance benefits breakdown. By being able to see each insurance benefit side-by-side, the consumer is then able to determine which insurance policy is the best for their family.