What is a deductible?
A deductible is the amount that a policyholder must pay for a claim before the insurance company will pay their portion. That is, if an insured event happens, the policyholder is responsible for covering costs up to a certain dollar amount, at which point the insurance company begins coverage. The aforementioned dollar amount is specified by your insurance company, within the confines of your specific policy. Most deductibles occur annually; that is, if two or more insured events happen in a given policy year, the deductible is only applied once. In some types of policies the deductible is per event or per person, not per year.
For example, if you have a dental insurance policy with a $50.00 deductible, you have to spend $50.00 of your own money before your insurer will pay whatever portion of the rest of the claim it has agreed to cover.
Please note, when providing “assignment of benefits” services, your dental provider may not be aware as to whether or not you have a deductible on your insurance plan prior to submitting a claim. Whether or not you have a deductible is in no way affected by your dental service provider, it is determined by your insurance company and the individual policy you have selected. The insured member (i.e. patient) is always responsible for payment on the day of service for any fees not covered by insurance.