What Is a Deductible?

A deductible is the amount you must pay out-of-pocket for covered medical services before your insurance begins paying its share. Once you meet your deductible, your insurance starts covering costs, though you may still owe copays or coinsurance for certain services.

How does a deductible work?

• Higher deductible plans: Often have lower monthly premiums but require more upfront spending before coverage kicks in.
• Lower deductible plans: Typically have higher premiums but cover costs sooner.
• Medicare and deductibles: Medicare has different deductibles for Part A (hospital stays) and Part B (outpatient care), which reset annually.

How does a deductible affect out-of-pocket costs?

• Applies to most non-preventive care: Doctor visits, hospital stays, and procedures often count toward your deductible.
• Does not apply to all services: Some plans cover preventive care, screenings, and vaccines before you meet the deductible.
• Once met, insurance kicks in: After reaching your deductible, you typically pay only copays or coinsurance.

How Solace can help

Understanding how deductibles impact your medical bills can be confusing, especially for Medicare beneficiaries navigating Part A and Part B costs. A Solace advocate can help estimate your out-of-pocket expenses, clarify what counts toward your deductible, and identify financial assistance programs that may lower costs.

What to do next

Need help understanding your deductible and healthcare costs? A Solace advocate can guide you through your plan and potential savings options. Find an advocate today.