What is a deductible?
A deductible is an out-of-pocket payment toward your health insurance claim. After the cost of care you receive hits that amount, your insurance either covers or splits the costs with you.
For example, if you have a $2000 deductible, you must pay $2000 before your health insurance benefits kick in. It’s essentially the amount you must pay before your health insurance starts to pay benefits.
Every year, your deductible resets. Some plans (like family plans) may have multiple deductibles (individual and family). Once you have paid the full deductible over the course of that year, your insurance company will shoulder costs. You'll still have to cover some costs like co-pays, so you deductible isn't the maximum amount of money you'll spend on healthcare that year (see out-of-pocket maximum).
Who receives my deductible?
Deductible payments are for the care you receive, and they go straight to the provider’s office or hospital giving you the medical care — not to the insurance company.
Do I always have to pay a deductible?
Not necessarily. For one, all ACA-compliant Marketplace plans must cover the full cost of certain preventive benefits before you’ve met your deductible. These includes things like annual physicals, vaccines, and other screenings.
Some plans also offer a $0 deductible, meaning that you don’t pay any deductible before your benefits kick in. These plans often have a higher monthly premium.