QUESTION

I have a $2,000 deductible but I don’t understand how it works. Can I not get any care covered until I meet that amount?

Post enrollment issues | Individual Health Insurance
ANSWER

A deductible is the amount you have to pay for services out-of-pocket before your health insurance kicks in and starts paying for covered services. Under the Affordable Care Act, preventive services must be provided without cost-sharing requirements like meeting a deductible, so you can still get preventive health care that is recommended for you.

Also, most plans must provide you with a Summary of Benefits and Coverage, which you can check to see if your plan covers any services before the deductible, such as a limited number of primary care visits or prescription drugs. (45 C.F.R. § 147.130; CMS, Affordable Care Act Implementation FAQ – Set 18).

Individuals with no coverage
Individuals with coverage
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Post enrollment issues