What is health insurance deductible(UnitedHealthCare) ?

  • by Gdgames G
  • Oct 07,2017
  • 12 answers

I recently got UnitedHealthCare with option #1, which has a deductible of $1750. And every paycheck, I pay around $60 for medical. My question is how does the deductible work ? How is the monthly payment related to the deductible ?
UnitedHealthCare Website has the following definition:
Deductible
The amount you owe for covered health care services before your health insurance or plan begins to pay. For example, if your deductible is $1,000 per year, your plan won't pay anything until you've met your $1,000 deductible for covered health services subject to the deductible for that year. The deductible may not be applied to some services, such as preventive services.
If I have been paying the monthly amount since January(and now it is October), I would have paid $60 x 10 = $600. So if I have a $1150 doctor visit, how much do I pay ?


LIKE OR DISLIKE:

  

Insurance Answers (12)

y 2 months ago

Got it through work, 60 bucks and only 1750 as a detectable, are really good. Your boss pays the rest of that monthly premium so it isn't 60x12 that will be paid. It's 60 x 12 plus what your boss through in, which is a hell of lot more then you pay per month.
The deductible includes copays and such, you see a doc, have a copay of 30 bucks, that goes to that 1750 total. Say the docs visit cost 3 or 4 hundred. You'll pay your 30, then get a bill for say 10 from the lab, another 1 or whatever from screening or whatever, insurance picks up the rest. Different % for you for each service depending on the deal the insurance company has made with that service. You get nickle and dime to death, until your deductible is satisfied, then they pay all. Of course the bigger the bill, the larger the amount you will pay but it is still a fraction of the total.

Help others find the most helpful reviews
Was this review helpful to you?  

H. Marie 2 months ago

health insurance is claimed on SCh A with any medical expenses and is limited to 10% of the excess of your AGI
If you have an HSA it is claimed after line #22 and reduces your gross income

Help others find the most helpful reviews
Was this review helpful to you?  

Barney 2 months ago

Healthcare is for liberal *******.

Help others find the most helpful reviews
Was this review helpful to you?  

amy lynn 2 months ago

The amount you pay for your insurance policy has no impact on your deductible. It is not included when calculating your remaining deductible.
Your deductible is the amount of money you will pay for medical services and prescriptions before your insurance starts to pay anything at all. So, if you go to the doctor and it costs $1000, then you will pay the full $1000 because it is below your deductible amount.
If you go to the doctor and the total bill is $2000, then you will pay $1,750 which leaves a balance of $250.
NOW, you did not mention if your plan has an "out of pocket" max that is above the deductible. If it does, then the plan would most likely pay 80% of that remaining $250 and you would still owe another $50 after your deductible.
Most insurance policies pay 80% after you reach your deductible amount until you pay enough to reach your out of pocket max for the year.

Help others find the most helpful reviews
Was this review helpful to you?  

Common Sense 2 months ago

Your premium (monthly payment) has zero relationship with the deductible. The monthly payment is to be INSURED only.
The insurance kicks in after you pay the first $1750. How this works is that the doctor will bill your insurance company for the amount of your visit. The insurance company will notify the doctor what they will and will not pay. The doctor will then bill you for your portion. Claims have to be filed so the insurance company can determine when to begin paying benefits.
Some policies have co-pays for doctor visits and prescriptions. READ your policy to find out when the deductible is used. Or, simply call the customer service number provided on the back of your insurance card.

Help others find the most helpful reviews
Was this review helpful to you?  

Judy 2 months ago

1150 if you haven't had any other medical expenses already that year that you paid for.

Help others find the most helpful reviews
Was this review helpful to you?  

StephenWeinstein 2 months ago

The monthly payment is not related to the deductible.
The monthly payment is what you pay each month for having insurance, whether or not you use the insurance.
The deductible is the amount you pay for using the insurance.
The monthly amount does not affect what you pay when using the insurance.
If you have been paying the monthly amount since January and have paid $600 in MONTHLY payments, and you have a $1150 doctor visit, then you pay the same amount as if you had paid nothing in monthly payments or ten million dollars in monthly payments.
For doctor visits that are only for preventative care, you pay nothing.
For all other doctor visits:
If the total of the cost of all your doctor visits for the year, when added together, is less than $1750, then you pay it all out of pocket.
If the cost of the cost of all your doctor visits for the year, when added together, is more than $1750, then you pay $1750 for the year (not for each visit) and the rest is shared with the insurance company. You pay the first $1750 for each YEAR, with no sharing, and then the rest for that YEAR is shared with the insurance company.

Help others find the most helpful reviews
Was this review helpful to you?  

lucy 2 months ago

Your $60 is what you pay to purchase insurance. That has nothing to do with your deductible, only that you have a health insurance policy.
You have a $1,750 deductible, so (until) you pay out of your pocket $1,750, then United Health Care (starts) paying. But, whenever you go to a doctor or have test done, they submit to United, who then (negotiates) the amount they can bill you, since United would have a contract of what they consider “reasonable” charges for any treatment.
Ie;
Go to your family doctor for an exam, and the doctor runs blood tests, which is then sent to a lab.
Doctor visit is $150 United lowers to $90
Blood tests is $400 United lowers to $280
Lab charges $100 United lowers to $75
So, instead of paying $650 that they can bill you (without) health insurance, then you will be billed $445, the difference of what United and the providers have agreed to.
So with the $445 you pay, then subtract that from $1,750 which is $1,305 left of your deductible.
Now let say that you go to the ER for breaking your leg from skiing;
ER room $1500 United lowers to $1,200
ER DR $250 United lowers to $175
X-rays $250 United lowers to $200
Radiologist $150 United lowers to $100
Cast/supplies $150 United lowers to $100
So instead of being billed for $2,300 for (no insurance) then you would be billed $1,775.
But now with the (prior) payment of $445 to your doctor plus the ER bill of $1,775 now totals $2,220, so you subtract out $1,750 which leaves a balance of $470, that United now (starts) to pay.
So at this point you pay $1,305, then most likely will pay 20% of the balance of the $470, since in most health insurance there is a 80/20 co-insurance clause. But that is another story, but the morale of the story is, that once you pay the deductible, then insurance starts to pay.
But, deductibles are yearly, meaning when the policy renews (most in January) then the deductible starts all over again.
Depending on your health or if any accidents, may find that you will not have enough in medical treatment for the insurance to pay, but, if you do, then that is when you want to have health insurance to pay for something sudden and unexpected/expensive vs paying (what) the doctors/hospitals can charge if you have no insurance.

Help others find the most helpful reviews
Was this review helpful to you?  

Stoo 2 months ago

Deductible is unrelated to your premium. Your premium enrols you in the insurance, which has a $1000 deductible. That means the first $1000 of any treatment is on you, and on top of the premium you pay - wihtout paying the premium, you get no coverage at all.
Don't like that, vote for politicians who'll implement single payer non-profit public insurance. In Canada, you go to the doctor and basic services and tests are covered - no co-pay, no premiums, no deductible, and it doesn't matter if you're employed or not since you're covered by virtue of citizenship, not ability to pay. You pay a bit more in taxes for this, but trust me, it's worth it.

Help others find the most helpful reviews
Was this review helpful to you?  

Insurance Pickle.com 2 months ago

Your premium is the cost of the plan. Your medical expenses apply towards the deductible. But, without looking at your particular plan, nobody here will know what types of expenses are subject to your deductible and what ones aren't. Could be everything, could be just hospitals and surgeries, could be everything except doctors' visits, etc...gotta read your plan summary.

Help others find the most helpful reviews
Was this review helpful to you?  

Ricki 2 months ago

Your insurance will not pay (except for specific things) for the first $1750 worth of medical expenses. Those are all yours. Then they will start to pay a portion of the amount over that and at some point, they will pay everything.

Help others find the most helpful reviews
Was this review helpful to you?  

Flower 2 months ago

The deductible is what YOU pay before United pays their portion of the bills every year. Is $60 a month your premium on an employer plan? Thats awfully low. Most people pay $200 a month. Your premiums of $60 a month has nothing to do with the deductible. The deductible is met by paying that much out for services, not premiums. Even if you've been paying your monthly premiums since January, you have to spend $1,000 before United will pay their 80% of bills after that point.

Help others find the most helpful reviews
Was this review helpful to you?  

Post a Answer

Your comment was successfully posted!

Or use your account on Blog

Error message here!

Hide Error message here!

Forgot your password?

Or register your new account on Blog

Error message here!

Error message here!

Hide Error message here!

Lost your password? Please enter your email address. You will receive a link to create a new password.

Error message here!

Back to log-in

Close