What Is a Health Insurance Deductible?
A deductible is the amount you must pay out of your own pocket for covered medical services before your health insurance begins to share the cost. For example, if your plan has a $2,000 deductible, you pay the first $2,000 of covered services yourself. After that, your insurance kicks in and you typically pay only a copay or coinsurance for services.
How Deductibles Work in Practice
Let's say you have a Silver plan with a $2,000 deductible and you need an MRI that costs $1,500:
- Before deductible is met: You pay the full $1,500
- After deductible is met: You'd pay only your coinsurance (typically 20-30%), so $300-$450
Most plans reset deductibles every January 1. Family plans have both individual and family deductibles — once one family member hits the individual deductible, their costs start being shared by insurance even if the family deductible hasn't been met.
Deductibles by Plan Type
- Bronze plans: ~$7,000-$8,000 deductible — lowest premiums, highest out-of-pocket before coverage kicks in
- Silver plans: ~$3,000-$5,000 deductible — mid-range. With cost-sharing reductions, can drop to $200-$500
- Gold plans: ~$1,000-$1,500 deductible — higher premiums but coverage kicks in faster
- Platinum plans: ~$0-$250 deductible — highest premiums, almost immediate coverage
These deductible ranges apply to both ACA marketplace plans and private ACA-compliant plans purchased directly from carriers. The only difference is whether your premium is reduced by subsidies (marketplace only).
Key insight: A lower deductible isn't always better. If you're healthy and rarely use healthcare, a high-deductible Bronze plan with lower monthly premiums can save you thousands per year — especially paired with an HSA. But if you have ongoing medical needs, a lower-deductible Gold or Silver plan pays for itself quickly.
What Doesn't Count Toward Your Deductible
- Monthly premiums — these are separate from your deductible
- Out-of-network services (unless your plan covers them)
- Services not covered by your plan
What's Covered Before You Meet Your Deductible
All ACA-compliant plans (marketplace and private) cover preventive care at $0 — no deductible required. This includes annual checkups, vaccinations, cancer screenings, and blood pressure checks. Some plans also offer copay-based primary care visits before the deductible is met.
Related Terms
Last updated: March 30, 2026.
