Is it better to have a deductible or no deductible for health insurance?
Asked by: Stephan Legros | Last update: December 16, 2025Score: 4.2/5 (22 votes)
Is it better to have a deductible or no deductible?
Higher deductibles are usually cheaper. If you don't visit the doctor very often, you will probably spend less per year in a normal year. However, you are covered if something unexpected happens like a surgery. Plans with a lower deductible are generally more expensive, but you reach your deductible faster.
Why is it not a great idea to have a high deductible?
Large medical expenses: Since HDHPs generally only cover preventive care, an accident or emergency could result in very high out-of-pocket costs. Future health risks: Because of the costs, you may refrain from visiting a physician, getting treatments, or purchasing prescriptions when they're not covered by your HDHP.
What is the downside of having a deductible?
Cons. Higher deductible: If your deductible is higher, it means you are required to pay for your medical care out of pocket up to that amount before your health plan begins to help pay for covered costs. The exception is for preventive care, which is covered at 100% under most health plans when you stay in-network.
Is $200 a month good for health insurance?
On average, in the United States, health insurance premiums for an Affordable Care Act (ACA) plan without subsidies are around $477 per month2. For a Silver plan, the average cost is about $621 per month. So, $200 a month is actually quite reasonable compared to these averages.
No Deductible Health Insurance vs High Deductible Health Plan (HDHP) | HOW TO CHOOSE & SAVE MONEY
What is the difference between a deductible and an out-of-pocket?
A deductible is the cost a you pay on health care before the health plan starts covering any expenses, whereas an out-of-pocket maximum is the amount a you must spend on eligible healthcare expenses through copays, coinsurance, or deductibles before the health plan starts covering all covered expenses.
Who should not use a high deductible health plan?
A chronic illness, such as heart disease or diabetes, can be much more expensive to manage under an HDHP than a traditional health care plan. With these conditions, regular medications and health screenings may be required. These costs may quickly add up until deductibles are finally met.
What is considered a good deductible for health insurance?
A plan that has a deductible of at least $1,400 (for individuals) or $2,800 (for a family) is considered a high-deductible plan. If your insurance plan has a low deductible, this means you may reach the threshold earlier and get cost-sharing benefits sooner.
Why would I want a low deductible health plan?
Having an LDHP can save you money if you have costly health issues or a larger family. The higher premium would be far less than what you would pay in deductibles and out-of-pocket maximums with an HDHP. For many people, paying a little more each month is easier than covering a large medical bill.
Why would someone want a high-deductible health plan?
HDHPs are popular because they have low monthly premiums. Because the premiums are lower than other health insurance plans, the deductible is higher. However, many HDHPs provide 100% in-network coverage for preventive services before you meet your deductible.
What is the difference between a PPO and a HMO?
HMOs (health maintenance organizations) are typically cheaper than PPOs, but they tend to have smaller networks. You need to see your primary care physician before getting a referral to a specialist. PPOs (preferred provider organizations) are usually more expensive.
What should you always do when purchasing health insurance?
Four things you should think about when choosing coverage - costs, provider network, benefits, and quality.
What if I can't afford my health insurance deductible?
Your healthcare provider can't waive or discount your deductible because that would violate the rules of your health plan. But they may be willing to allow you to pay the deductible you owe over time. Be honest and explain your situation upfront to your healthcare provider or hospital billing department.
Is it cheaper to have health insurance or pay out-of-pocket?
People without insurance pay, on average, twice as much for care. This means when you use a network provider you pay less for the same services than someone who doesn't have coverage – even before you meet your deductible.
Do copays count towards deductible?
No. Copays and coinsurance don't count toward your deductible. Only the amount you pay for health care services (like the medical bill you receive) count toward your plan's deductible.
Is a $0 deductible good for health insurance?
Health insurance with zero deductible or a low deductible is best if you expect to need major medical care in the upcoming year. Even though you'll pay more for the plan, it will help you save overall because the full benefits begin right away.
What is a good premium for health insurance?
PREMIUMS FOR SINGLE AND FAMILY COVERAGE
The average premium for single coverage in 2024 is $8,951 per year. The average premium for family coverage is $25,572 per year [Figure 1.1].
Is it better to have a deductible or not?
It depends on your health needs and your budget. If you and your covered family members are in good health and don't often see a doctor, a high-deductible plan may be a better option. But if you think you or your family members may need to seek medical care often, a low-deductible plan may be the best fit.
What is a disadvantage of having a high deductible?
Namely, you're responsible for paying a larger portion of your healthcare expenses out of pocket. This can be a significant financial burden for those with a lot of medical expenses and could lead to financial strain. HDHPs may not be the best choice for those with chronic or frequent medical needs.
What is a normal deductible for health insurance?
What is a typical deductible? Deductibles can vary significantly from plan to plan. According to a KFF analysis, the 2024 average deductible for individual, employer-provided coverage was $1,787 ($2,575 at small companies vs. $1,538 at large companies).
Do high deductible plans cover prescriptions?
These plans have higher deductibles.
That means you pay for doctor visits, tests and prescriptions until you meet your deductible, then and your plan begins to pay.
Do prescriptions count towards the deductible?
Any amount you pay for the drug generally will count toward your deductible and/or maximum out-of-pocket limits.
Is it better to have a low deductible or low out-of-pocket?
The out-of-pocket max is most important if you need ongoing medical care or expensive treatments. In these situations, choosing a plan with a lower out-of-pocket max is the best way to lower your total costs.
What happens when you meet your health insurance deductible?
Once a person meets their deductible, they pay coinsurance and copays, which don't count toward the family deductible.