Say my deductible is 1500 and I need a procedure that’s costs $1000 but my insurance will cover 50% before deductible. A few months before the procedure I managed to meet my deductible though does that mean they will cover 100% of it or the 50% still?

If possible try to explain like I’m five

  • @GlendatheGayWitch
    link
    22 months ago

    Don’t forget, insurance covers 50% before the deductible is met, not after. When a policy has that verbiage, usually there’s a footnote that states how those claims are handled in the future. From what I’ve seen, that could mean that insurance will cover 100% of said procedure after the deductible is met or it could mean a co-insurance of 30%.

    After the deductible is met, OP won’t necessarily pay 50%. The percentage of the bill that OP and/or insurance will pay will be on a footnote at the bottom of the blue plan overview page (at least it’s blue when looking at plans from the ACA marketplace).