What a health insurance deductible is

HealthCare.gov defines a deductible as the amount you pay for covered health care services before your insurance plan starts to pay. In the glossary’s example, a $2,000 deductible means you pay the first $2,000 of covered services yourself.

After that, you usually pay a copayment or coinsurance for covered services, and the insurer pays the rest. A copayment is a set dollar amount. Coinsurance is a percentage. The out-of-pocket maximum is a different number: the cap on what you pay for covered in-network care during the plan year. The deductible is not that cap.

What the glossary also says

• Many plans pay for some services, such as a checkup or a disease-management program, before you meet the deductible. You have to read the plan.
• All Marketplace plans pay the full cost of certain preventive benefits even before the deductible is met.
• Some plans use a separate deductible for a service such as prescription drugs.
• Family plans often have an individual deductible for each person and a family deductible for everyone on the plan.
• In general, plans with lower monthly premiums have higher deductibles, and plans with higher premiums have lower deductibles. That is a pattern, not a promise about a plan sold in Broward County.

How to use the number

A low deductible is not automatically the better buy. You also pay a premium every month whether you see a doctor or not. Comparing plans means putting the premium next to the deductible, the coinsurance, and the out-of-pocket maximum, then asking which doctors and drugs are on the list.

If you live in Sunrise or elsewhere in South Florida, the plans you can actually buy still depend on your ZIP code, the year, and whether you are in an enrollment window. An advisor can walk through the documents. This page cannot.