Problems with the Yearly Health Insurance Deductible

Part 2, Chapter 4: Traditional Individual and Group Plans, Doctors' Bills Page 4

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Problems with the Yearly Deductible

In theory, keeping track of the yearly major medical deductible -- the amount you need to pay each year before the insurer begins to provide reimbursement for major medical claims -- should be simple. In reality, it seems to represent one of the most common sources of confusion for consumers. There are two difficulties. First, insurance companies don't necessarily subtract the deductible from the first major medical claim of the year. In fact, in some cases, a number of claims may be processed before the deductible is subtracted.

Second, certain medical tests such as X-rays and blood tests may be covered under the basic benefits provision of the policy, and reimbursement may therefore be provided by the insurer even though the deductible has not yet been met. As a result, you may find that a number of bills are paid in full at the beginning of the year even though the deductible has not been subtracted.

As difficult as it may be to keep track of the deductible under those conditions it's important to do so. One of the advantages of using the record keeping system discussed earlier is that the system makes it easy to keep track of the deductible. Using that record keeping system will help to ensure that you are always aware of the point at which the deductible has been met for the year.

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