The definition of Deductible, and how it fits into the Zenefits Health Insurance Marketplace

What is a deductible?

A deductible is the amount of money someone has to pay out of pocket for medical expenses before health insurance kicks in and begins covering the expenses.


How does a deductible work?

An example of a deductible would be if an employee is covered by a $2000 deductible plan and incurs $1750 in medical expenses this year. The insurance carrier will not cover any of that amount, with the exception of any services that explicitly waive the deductible.

Once the deductible is met, enrollees are still responsible for paying coinsurance or copays up to a maximum amount (out-of-pocket max) specified by their plan. Keep in mind that not all plans and services require copays, so check the Summary of Benefits and Coverage for more information.