Health Insurance Deductible

Everything You Need to Know About Health Insurance Deductible

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The catastrophic viral pandemic has certainly created an open dialogue about the importance of health insurance. Everyone is trying to get their hands on the best health insurance plan available. Health cover is a great way of securing your finances in the case of medical treatment and/ or care. People want to purchase the top health insurance in the market for themselves or their close ones but it is vital that you read the fine print and understand exactly what kind of coverage you want to, or can pay for. 

Health insurance providers use a lot of complicated jargon to convey convoluted information. These terms can end up confusing those who want to invest in a health cover. One such term is the word “deductible”. What does it mean?

What Exactly Is a Health Insurance Deductible?

The health insurance deductible is a term that often crops up in terms of health cover and health benefit plans. A deductible refers to the amount of money that you pay for your insurance claim before the insurance company starts paying for it. What it means is that you pay a certain agreed-upon price, and the rest is paid by your insurance. Your insurance provider will pay for particular medical costs after you chip in with the fixed amount, ie., the deductible.

For example, you have taken a plan with ₹35,000 health insurance deductible and you incur a hospital bill of ₹1,00,000. The first ₹35,000 of the bill will have to be paid from your pocket, after which the insurer will clear the rest of the bill.

A health insurance deductible, however, is only applicable on the first claim every year. So, if you have raised more than one claim in a year, your insurance will cover the entire bill from the second claim onwards.

How Is a Health Insurance Deductible Different from Paying from Your Wallet?

It might seem that paying a deductible and paying the whole amount by yourself is practically identical. After all, you end up spending a certain amount on your part, so why pay for health insurance at all?

Turns out, opting for a health insurance deductible saves you from paying the double amount of what you would have to part with. When you purchase a health cover, you use it to lessen your expenditures for medical care or unforeseen health problems. Rising hospital costs can make healthcare inaccessible to many. A comprehensive care health insurance helps a load off the total cost to not pay huge amounts.

Therefore, instead of paying the whole amount all by yourself, you share costs with your insurance provider. If you are hoping to save costs, getting affordable health insurance for yourself is your best bet.

What Services Do You Have to Pay a Deductible On?

Now that we know what a deductible is, the next most pressing question comes up. Do you have to pay a deductible for all provisions, or are there certain services that require the payable amount?

Preventive services do not require you to pay a health insurance deductible. Any routine checkup that you get done to prevent an illness comes under the purview of preventive services. 

Services can include vaccines, annual physical checkups, cancer screenings, counseling on topics like giving up smoking, inculcating healthy habits, etc. Nonetheless, you may have to cough up some sort of coinsurance or copayment even if you don’t have a deductible.

Health insurance deductibles are applicable, especially applicable on hospitalization expenses. Such treatments may also include blood work, radiology, ultrasound, and various other pathological and laboratory tests. These expenses will require you to pay a deductible for the services rendered. Some diagnostic tests are carried out during yearly physical checkups. Thus, you should talk to an insurance provider to get a clear idea about payment plans to avoid extra charges.

How Is the Deductible Amount Decided?

All this while, we have been talking about an agreed-upon amount that you pay as deductible for medical care. The question that follows is: who decides on that amount?

Well, the onus on choosing a deductible plan lies on the policyholder, that is, the person who buys the insurance. The higher amount of the health insurance deductible you have, the lower your cost of insurance will be.

It all depends on how much compromise you are willing to share through the deductible with your insurance provider. If you agree to a higher deductible, the risk lessens considerably for the insurance company. Your provider may agree to reduce the amount of your premium.

If you are prepared to pay more, you end up saving money. Speak to your insurance providers for the best health insurance plan if you are inclined to take up the offer. 

Your premiums depend on the amount of health insurance deductible you can afford. The lesser the deductible amount you choose, the more risk your insurance provider has to solder. This leads to an increased amount that you have to pay for premiums.

Final Words

With medical inflation on the rise, healthcare expenses have witnessed an explosive surge. Opting for health insurance deductibles in your plan can you help you opt for a larger, more comprehensive health cover without burning a hole in your pocket. It is an especially good option for family floater policies where the premiums increase with the number of dependents, especially if the cover also includes the policyholders’ parents. 

While a health insurance deductible might seem like quite a hassle, considering it is an out-of-pocket expense, it can go a long way in further cutting down your healthcare spends.


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  2. Hello Vital,

    Thank you for sharing such a detailed post on the deductible. You have discussed deductible from multiple angles. That makes sense even for a layman.

    I love the section about how the deductible amount is decided. Now I am very clear that it purely depends on the policyholder. This is a win-win condition for both the insurance company and the policyholder.

    Keep sharing such blogs on other terms related to health insurance to educate people as well as motivate new bloggers who looking for such information. I will share your blog to keep my connection updated.

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