What is a deductible?
Learn about deductibles and how to track them.
A deductible is the amount you pay each year for covered healthcare before your health plan begins to pay.
How does a deductible work?
Most health plans have a deductible, but the amount can vary from one plan to the next. A plan with a higher deductible often has a lower monthly premium. Plans with a lower deductible generally have a higher monthly premium.
The deductible amount also can vary depending on where you get healthcare. Some plans have different deductibles for care you receive outside of the network. Typically, you pay less when you get care from a doctor in your network.*
Learn more
Find out how deductibles work with other healthcare costs and learn how and who to pay for healthcare.
Deductible example
How do I track what I've paid?
Your health plan tracks how much you’ve paid toward your deductible. Each time you receive care, your plan sends you an Explanation of Benefits (EOB).
The EOB shows how much of the cost applies to your deductible.
Example of how deductibles work:
- Adam’s plan has a $2,500 deductible.
- He visits an emergency room at a hospital in his plan network.
- Blue Cross sends Adam an Explanation of Benefits (EOB) showing he owes $500 for the emergency room visit. Adam pays $500 to the hospital.
- Blue Cross tracks Adam’s payment of $500 toward his $2,500 deductible. If Adam seeks medical care in the future, he still has $2,000 to pay to meet his deductible. Once he reaches his deductible, he will share the cost for covered care with his plan. This cost sharing is known as coinsurance.
Learn more about coinsurance
This is general information about how plan benefits work. Review the Summary of Benefits and Coverage and your specific health plan benefit booklet for information about how your plan works.
*It’s up to you to always check if your provider is in your health plan network before you receive services. Not all providers are in every network. You may pay more or for all of your healthcare costs if your provider is out of your network or does not have a contract with Blue Cross (this is called a non-participating provider). You can verify if your provider is in your network by calling customer service at the number on the back of your member ID card.