Why are deductibles charged?
Asked by: Elwyn Beahan | Last update: November 5, 2025Score: 5/5 (23 votes)
Why am I being charged a deductible?
The deductible is the amount of risk you've accepted to be responsible for when filing a claim through your own insurance. It's to prevent people from repeatedly filing false claims to receive a payout and get ahead financially. Plus it reduces the amount of premium you pay the higher the deductible amount is.
What is the point of paying a deductible?
An insurance deductible is one of the major out-of-pocket expenses associated with an insurance policy. This is the amount that policyholders must pay out for an insured loss before coverage starts. Understanding how deductibles work is crucial in helping individuals and businesses get the most out of their policies.
Is it better to have a $500 deductible or $1000?
Generally speaking, yes, a higher deductible is the better choice long term. Especially if you have a good driving history.
Do you get money back from a deductible?
Yes. The insurance company will refund the amount you overpaid. Generally, once you have met your deductible then it goes to a split between you and the insurance company. So say your split is 80/20. You pay 20% of the bill until you reach your max out of pocket. Then you pay nothing for the rest of the year.
How insurance premiums and deductibles work
How to avoid paying deductible?
- Choose not to file a claim until you have the money.
- Check your policy, as you may not have to pay up front.
- Work out a deal with your mechanic.
- Get a loan.
Is everything free after deductible?
A deductible is the amount you pay for coverage services before your health plan kicks in. After you meet your deductible, you pay a percentage of health care expenses known as coinsurance. It's like when friends in a carpool cover a portion of the gas, and you, the driver, also pay a portion.
Why do I have to pay my deductible if someone hits me?
Policyholders will generally pay the deductible before comprehensive coverage kicks in. Liability insurance. Liability coverage, which is required in California, doesn't involve deductibles but covers damages the policyholder causes to other vehicles, drivers, or property.
What is a disadvantage of having a high deductible?
Cons of High Deductible Healthcare Plans
Individuals who are stretched thin for funds may delay or avoid seeking medical treatment due to the high cost of treatment. For example, someone injured may avoid the emergency room if they know it will result in an expensive bill that will be applied to the plan deductible.
What happens if my repairs cost less than the deductible?
What if my car repair costs less than my deductible? There may be times when your car insurance deductible is more than the cost of the damage to your vehicle. Unfortunately, in these cases, you'll need to pay for all repairs out-of-pocket. This is because insurance only pays for damages that are above your deductible.
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.
What if I need surgery but can't afford my deductible?
In cases like this, we recommend contacting your insurance, surgeon, or hospital and asking if they can help you with a payment plan. Remember that your surgery provider wants to get paid so they may be very willing to work with you on a payment plan.
Is it illegal to not pay your deductible?
If you do not pay your deductible you are committing a crime. Technically, this is a form of insurance fraud. Most homeowners' insurance policies will have a concealment or fraud section.
Why do deductibles exist?
Insurance policies use deductibles to ensure a measure of financial stability on the part of the insurer by reducing the severity of claims. A policy that is properly structured provides protection against catastrophic loss. A deductible provides a cushion between any given minimal loss and a truly catastrophic loss.
How is deductible waived?
In some cases, the deductible may be waived because the service is already free or at a low cost under your plan. This is often the case with preventive services. For example, an annual wellness visit may only cost you $20, but that $20 might not count toward your deductible.
Do I pay my deductible to the Body Shop?
You typically pay your car insurance deductible after your car is fixed. Depending on your insurer and the situation, your insurer may pay the repair shop directly, minus your deductible — if that's the case, you'll need to pay the repair shop your deductible.
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.
Does copay 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.
How high is too high deductible?
In 2023, health insurance plans with deductibles over $1,500 for an individual and $3,000 for a family are considered high-deductible plans.
How do I get my deductible back?
Getting Your Deductible Back
This is called subrogation. Your insurance company will pursue the at-fault driver's insurance company to recover the money paid for the damages, including your deductible. The time it takes to get your deductible back can vary depending on the specific circumstances of your case.
What gets charged to your deductible?
The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.
What happens if you can't pay your insurance deductible?
If you cannot pay the full deductible up front after an accident, some repair shops may work with you on a payment plan. If you cannot pay the whole deductible, some shops may not start the repairs right away. Depending on your policy, your insurance company could also refuse to pay until you have paid your portion.
Why do doctors bill more than insurance will pay?
It is entirely due to the rates negotiated and contracted by your specific insurance company. The provider MUST bill for the highest contracted dollar ($) amount to receive full reimbursement.
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.
How much is Obamacare a month for a single person?
Monthly premiums for Affordable Care Act (ACA) Marketplace plans vary by state and can be reduced by premium tax credits. The average national monthly health insurance cost for one person on an Affordable Care Act (ACA) plan without premium tax credits in 2024 is $477.