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Understanding Health Insurance Deductibles

At Highmark Blue Shield of Northeastern New York, we know that health insurance can be complicated. We're here to help you better understand health plan deductibles and what they mean to you.

Click on the sections below to learn more:

My health plan has a deductible, what does that mean?

To help keep premium costs lower, some health care plans have a deductible. A deductible is the amount of money a member pays out-of-pocket before paying a copay or coinsurance. The amount paid goes toward the out-of-pocket maximum.

  • Need an explanation of health care terms we use? Visit our glossary
  • Think of your health insurance deductible like your auto insurance. You pay a monthly premium for coverage, but when the time comes for a claim, you pay your deductible first. Unlike auto insurance deductibles, many health plans provide some benefits before you meet the deductible —such as free, preventive services.
zero dollar preventive services include routine annual physical, immunizations, screenings. check with plan for costs before service.

So, how does a deductible work?

  • Member pays toward deductible.
  • Deductible is met. Member pays copays/coinsurance toward out-of-pocket maximum.
  • Out-of-pocket maximum met. Health plan pays 100% of all medical expenses moving forward. 
how a deductible works infograph

To give you an example:

example health plan with deductible infograph