What’s the Deal with Deductibles?

How I Feel About DeductiblesIf you’re like me, you constantly forget that your health insurance comes with a deductible. What’s ironic though, is that the reason I usually forget about my deductible is because so many things are covered without needing to meet the deductible first. So I forget it even exists. Then I do something out of my norm and see a specialist or get an x-ray, and BOOM, there’s Mr. Deductible. He’s standing at the door, ready to be let in. I ignore him. He starts texting me instead. Sooner or later, he tells me, we were bound to meet.

So what’s the deal with deductibles? In short, your deductible is the amount of money that you pay first, before your health insurance starts to pay. If you have a $1,000 deductible, in theory you pay the first $1,000 of health-related expenses, and once you reach that number, then your health plan’s benefits kick in. But I find that many of the things I do most often, such as going to the doctor or filling a prescription, are services that are NOT subject to my deductible. That’s a good thing, I know, yet I still get cranky about the rare times that my deductible comes into play.

But I imagine that your real question is *why* do health plans have deductibles at all? Well, health insurance started out like home insurance and car insurance. It was meant to insure against unplanned disasters. Premium rates were based on the idea that most homes aren’t going to burn down, and that most of us will not have our cars totaled. And for health insurance, that most of us will hopefully not spend three months in a hospital.

But health insurance changed over time. Your homeowner’s insurance doesn’t pay for the sealer that keeps your deck protected, but your health insurance typically pays for dental care that keeps you from getting cavities, and tests that catch problems early. In short, you use your health insurance all the time, whereas you hope that you almost never have to use your homeowner or auto insurance. When we overuse our health insurance though, going to the doctor for every little thing, ordering a full range of advanced tests before trying the simpler tests, we drive up health care costs for everyone. Ourselves included!

So deductibles, no matter the type of insurance, are there to make me stop and think before I pursue something. If my homeowner’s insurance didn’t have a deductible, I’d want to claim every dented piece of siding on my house, every roof tile that has come unstuck, and so on.

Your health is important, and you shouldn’t let a deductible stop you from having important services. But I admit that knowing I will pay a big chunk of change for an x-ray really makes me stop and think, “Can I wait another week and see if the pain in my knee lessens before we order a whole series of those?” And now that I work for a health insurance company, I can see that using my benefits judiciously makes me part of the solution. And I like that.

But I still get to be cranky about my deductible. It’s just who I am.

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