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Deductibles and health insurance on the Health Insurance Marketplace®


published to November 20, 2015

To find the best marketplace health insurance plan for your family, you need to consider various factors such as premiums, annual deductibles, covered services, and other details. Insurance premiums can often be the deciding factor, but other considerations can be just as important.

Breakdown: deductible

a

is the amount due for medical services covered by the plan before the health insurance plan begins paying.

Here are five things you should know about Marketplace plan deductibles:

  1. All Marketplace plans cover recommended preventative services with no deductible. Services such as cancer screenings, vaccinations, and pediatric checkups are always covered without the need to pay deductibles, copayments, or other costs.
  2. Many other medical services are often covered without a deductible. Many health insurance plans offer some benefits before meeting the deductible. These plans may allow you to visit your doctor or fill out a generic prescription and pay only out-of-pocket. Specialist visits, mental health outpatient services, and even brand-name medications are often covered without deductibles, but still have co-payment or co-insurance liability.
  3. Check out what the plans cover without deductibles. Coverage varies by plan. Once you’ve found a plan you like online, look under “Medical Expenses” to see which services are deductible and which aren’t. You can also click on a plan to see a detailed explanation of how the plan’s deductibles apply to different services, or to see examples of specific types of care .
  4. Consider services covered without deductibles and other out-of-pocket costs when choosing the right plan. It’s important to understand what your insurance company covers even if you don’t pay the deductible. You can then decide whether you want a plan with a low monthly premium and a high deductible, or a plan with a high monthly premium and a low deductible.you 2016 insurance plan previewyou’ll see an estimate of your total out-of-pocket costs, including deductibles and co-payments, to help you make this decision.
  5. The Silver plan saves even more. You can save even more if you qualify for reduced cost sharing, as most consumers who sign up for our Marketplace Policy do. Her family of four, with incomes under $60,625, can qualify for additional savings with lower copays, lower deductibles, and more services covered without deductibles. This financial assistance is only available with the purchase of the Silver plan. As such, the monthly fee for the Silver plan may be higher than other plan options, but consider the total cost. Eligibility can reduce your maximum out-of-pocket expense by thousands of dollars a year, as well as reduce your deductible. See if you qualify for these savings.

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