💰 Benefits & Hearings

Deductible

What it means

The amount of money a patient pays for health care before insurance kicks in. With a deductible of, say, several hundred dollars, the patient pays the first stretch of medical bills out of pocket. After that, insurance covers its share (minus any co-pay). Deductibles reset every year. Medicaid in New York generally has no deductible — services are covered from day one. Marketplace plans (NY State of Health) have deductibles that vary by plan level: bronze plans have higher deductibles and lower premiums; silver and gold have lower deductibles and higher premiums.

When you might hear this

You hear this with health insurance. It is the amount you pay out of pocket before insurance starts covering costs. Medicaid in New York generally has no deductible.

What to ask

  • What is my deductible, and how much have I used so far this year?
  • Does this service count toward my deductible?
  • Are there services covered before the deductible is met?
  • Does Medicaid have a deductible?
Source
Common insurance term — Read the law
Checked: 2026-04-16
This is for understanding only. It is not legal advice. If you are in a case, talk to a lawyer.