Medical Deductibles
Take Advantage of Your Benefits, Consider Planned Care Now.
If you've met or are close to meeting your health insurance deductible, now may be a great time to schedule the care you've been delaying. Your out-of-pocket costs may be lower before the end of your plan year, depending on your coverage.
Whether you need an orthopedic procedure, heart health screening or hernia repair surgery, don't wait until the holiday rush. Schedule your appointment now to make the most of your benefits and secure a convenient appointment time. Coverage and costs vary by plan, so be sure to check with your insurer.
What Is a Medical Insurance Deductible?
Your deductible typically applies during a specific plan year. Once you meet it, you may still pay a copayment or coinsurance for covered services. Your monthly premium keeps your insurance active. Your deductible applies when you receive covered care. Costs may also vary based on whether:
Your deductible applies to covered services until you reach the amount set by your plan. For example, with a $2,000 deductible, you may pay the first $2,000 of eligible covered services.
Some preventive services may be covered before you meet your deductible, depending on your plan. Your insurance may also include separate deductibles for prescription drugs, family members or certain types of care.
- An orthopedic procedure or joint replacement
- A heart health screening or cardiology procedure
- Hernia repair surgery
- Gallbladder surgery
- Another medically recommended elective procedure
Frequently Asked Questions
Need more information? Let us follow up with you.
By submitting this form you agree to receive periodic health related information and updates. We welcome your comments, questions and suggestions. We cannot give you medical advice via e-mail. To discuss any medical symptoms or conditions contact your physician or other healthcare professional. In the case of a medical emergency, call 911 or go to the nearest emergency room immediately.
How May Your Deductible Affect Care at Palm Beach Health Network?
Palm Beach Health Network provides care across Palm Beach County and nearby communities, including Boca Raton, Delray Beach, Palm Beach Gardens and West Palm Beach. Florida Coast Medical Center also serves patients in Port St. Lucie and the Treasure Coast.
Elective Procedures
Cardiology Procedures and Screenings
Cardiology services and heart health screenings may include:
- Electrocardiograms, also called ECGs or EKGs
- Echocardiograms
- Exercise and stress tests
- Cardiac CT and coronary screenings
- Cardiac catheterization and angiography
- Heart surgery and other cardiac procedures
- Cardiac rehabilitation
General Surgery Procedures
General surgery care may include treatment for abdominal wall hernias and gallbladder disease. Your care team can explain the procedure, expected steps and recovery. Ask your insurance company how your benefits may apply.
Orthopedic Procedures
Orthopedic care may include joint replacement, spine surgery, foot and ankle care, rehabilitation and orthopedic robotic surgery. Ask your insurance company how your remaining deductible, copayments and coinsurance may apply to the care you are considering.
Podiatry Procedures
Common elective podiatry procedures include bunion removal to realign the big toe joint, hammertoe repair, plantar fasciitis treatment, neuroma removal and flatfoot reconstruction to improve mobility and reduce pain. Check with your insurance company to learn how your deductible, copayments and coinsurance may apply to the care you're considering.
Does Elective Surgery Count Toward Your Deductible?
Elective surgery may count toward your deductible when it is covered by your insurance plan. Coverage may depend on medical necessity, prior authorization, the procedure, the facility and your plan’s network requirements.
Planned procedures may include hernia repairs, gallbladder surgery, joint replacement and other general surgery procedures. Cosmetic or non-covered procedures generally may not apply to your deductible. Confirm your benefits before scheduling.
Do You Pay Medical Deductibles for Outpatient Treatment?
You may pay toward your deductible for covered outpatient treatment, depending on your plan. Outpatient care may include physician visits, imaging, diagnostic testing and same-day surgery. Outpatient treatment may involve separate charges from the physician, facility, anesthesia, imaging or laboratory providers. Ask which providers are involved and whether they participate in your insurance network.