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The Deductible

Today’s video and associated copy are the last of our reruns associated with this holiday season. This video first ran in 2021. The copy below has been updated with 2024 figures. Many benefit periods have a January 1 start date so that is a good time to familiarize yourself with various deductible amounts.

We wish all of you a very happy 2024. Check back next week for new material. Thanks.

The deductible is the annual amount you owe before your insurer pays although there are some services like well-care or other visits often covered before meeting the deductible. The tricky issue with deductibles in healthcare is that there can be so many of them and they can range from zero to thousands of dollars.

Some people have separate pharmacy, in-network medical and out-of-network medical deductibles. Others have plans where all claims expense accumulates against an aggregate deductible. Some have plans that allow all in-network claims to be applied to the out-of-network deductible. Still others have an embedded deductible where one individual in a family can meet an individual deductible and all other family members’ claims aggregate against the family deductible.

And then there’s Medicare. In 2024 the Part A Medicare deductible is $1,632 for each benefit period (not an annual deductible) and the annual Part B deductible is $240. Advantage Plans (Medicare Part C) have varying deductibles. Many are zero deductible plans but with copayments for most services. Medicare Part D plans are limited to an annual deductible of no greater than $545 in 2024 but many Part D companies offer various plans with different deductible levels.

Because this is so vexingly complex, mistakes are made. If you have no idea how your deductibles are structured or the amount, then you are in no position to know when you get a bill that might overcharge you. Always maintain an on-line account on your insurance company’s website portal so that you can review how your plan is structured and how claims are applied against the deductible over the course of the year.

Trust is an admirable trait. In our opinion, however, to trust that all your claims are processed flawlessly against various deductibles is deeply unwise. If you care about your money, take the time to understand how your deductibles work.