Deductible

Extended Definition

A deductible is the amount you pay for covered services before your insurance begins paying its share. Once you meet your deductible for the year, insurance starts covering its portion of costs.

How Deductibles Work

Example with Medicare Part B ($240 deductible):

1. Your first doctor visit costs $200
2. You pay $200 (toward deductible)
3. Your deductible remaining: $40
4. Next visit costs $150
5. You pay $40 (to meet deductible) + 20% of $110 = $62
6. Deductible met for the year

Common Deductible Amounts (2024)

Plan Type	Typical Deductible
Medicare Part B	$240/year
Medicare Advantage	$0-$500+
Private insurance (employer)	$500-$2,000
High-deductible health plan	$1,600-$8,050

Deductible Strategies

Time treatments strategically:

• If deductible is met, schedule elective procedures
• Early-year treatments apply to new deductible
• Late-year treatments may carry over

Understand what counts:

• Most covered services count toward deductible
• Premiums don’t count
• Non-covered services don’t count
• Copays may or may not count (varies by plan)

Deductible vs. Other Costs

Cost Type	What It Is
Premium	Monthly payment for coverage
Deductible	Amount before insurance pays
Coinsurance	Your % after deductible
Copay	Fixed amount per service
Out-of-pocket max	Yearly spending limit

Tips for Joint Pain Patients

• Know your deductible status before treatment
• Ask for cost estimates including deductible impact
• Consider timing of elective procedures
• Medigap plans can eliminate deductible concerns