Your health insurance deductible is the amount of money you have to pay per year out of pocket before your insurance company will cover any charges. Your insurance company —not FMA — determines the amount of your deductible based on your individual plan.
Here’s how it works: You come to the office for a visit. You pay your copay, which is also set by your insurance company. FMA sends the information about your visit to your insurance company for payment.
- If you have not yet paid your entire deductible amount out of pocket, your insurance company informs FMA, and FMA bills you directly for the charges. This process will continue until you have paid your entire deductible out of pocket.
- If you have already paid your entire deductible amount out of pocket, your insurance company will pay the charges according to your plan.
For example, if your deductible is $500, you must pay medical bills out of pocket until you have spent a total of $500. Your insurance company keeps track of the payments you make. When you have fulfilled your $500 deductible, your insurance company begins to pay, according to your plan.
Some insurance plan deductibles apply to individuals, and some apply to entire families. Usually the amount of your deductible is based on the overall cost of your insurance: plans with a lower overall cost require a higher deductible, and plans with a higher overall cost require a lower deductible. Depending on how your buy your health insurance — personally or through an employer — you might be able to choose a plan with a higher or lower deductible.
If you need more information about your deductible, please contact your insurance company or your employer’s benefits department. Many insurance companies offer comprehensive websites. Patients can log on with an ID number and password and get information about their specific coverage as well as recent activity.
The FMA billing department does not have the necessary information about your insurance plan to answer your questions.