Georgia Navigator Practice Exam

What is a deductible?

1. A specific amount paid after a claim is approved

2. The total healthcare cost for a year

3. An amount paid before an insurer covers a claim

4. The maximum amount for out-of-pocket expenses

The correct answer is: An amount paid before an insurer covers a claim

A deductible is the amount that an individual must pay out-of-pocket for covered healthcare services before their insurance plan begins to pay. This means that the insured is responsible for covering this specified amount for their medical expenses or claims before the insurer contributes to further costs. Typically, deductibles reset annually, meaning that a new deductible must be met each year before the insurance coverage takes effect for certain services. This concept is integral to how many health insurance policies function, as it encourages policyholders to share in the costs of their healthcare. Deductibles can vary in amount, depending on the specific insurance plan, and are an important factor in determining the overall out-of-pocket expense for individuals seeking medical care.