Deductible
Updated September 30, 2026
Definition
The amount you pay for covered care before your health plan starts to pay its share. It usually resets once a year.
A deductible is the amount you pay for covered care before your health plan starts to pay its share. It usually resets once a year. Until you meet it, you often pay the full allowed amount for your care.
Not everything waits for the deductible. In most cases, you won't pay a copay or coinsurance for certain preventive care, like vaccines and screening tests, from an in-network provider. That's true even if you haven't met your deductible.
For example, say your deductible is $2,000 and you have a $1,500 surgery in March. You pay the full $1,500. Your next $500 of covered care also counts toward it. After that, you usually pay only copays or coinsurance until you reach your out-of-pocket maximum. Your explanation of benefits (EOB) shows how much went to your deductible. See our guide to medical bill vs. EOB.
Related terms
Guides that use this term
- GuideMedical bill vs. EOB: how to compare them line by lineYour bill and your EOB should tell the same story. Here's how to compare them in 20 minutes, with a worked example and what to do if they don't match.
- GuideHow to choose a health insurance plan and avoid big billsCompare health plans by total yearly cost, not just the premium. Check networks, doctors, drugs and the SBC, with a worked example and 2027 deadlines.
Sources
- Deductible (glossary), HealthCare.gov. Accessed September 30, 2026.
- Preventive care benefits, HealthCare.gov. Accessed September 30, 2026.
- Health insurance terms you should know, Centers for Medicare & Medicaid Services. Accessed September 30, 2026.
This is general information, not legal or medical advice. Rules can depend on your plan and your state. Romi Care isn't an insurer, law firm, collection agency, or government program.