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Ask the Health Insurance Expert

How does the deductible work when you lose health insurance? Do you just lose the money and have to start again with the new health insurance company?

Yes, you “lose” the money you paid out under your previous health plan.

A health insurance deductible is the amount you pay out-of-pocket before your health insurance plan begins to cover health care costs.  Annual deductible amounts vary according to the health insurance company you have and the plans that it offers. Annual deductibles are based on the calendar year, even if your health insurance plan is not.

If you change plans (for instance, from group to individual) or health insurance companies during the calendar year, your deductible amount resets, meaning you don’t get credit for the money you put toward your deductible amount thus far.

For example, if by June you’ve already met your current health insurance provider’s $1,000 deductible, your next covered medical expenses should be paid 100 percent by your health plan, minus any copayments or co-insurance you’re required to pay.

If, however, by mid-June you lose your job and start a new job (whose health plan you enroll in once you’re eligible), your new health insurer won’t take into account the deductible money you’ve already spent. Thus, if the new deductible is also $1,000, the previous $1,000 you spent doesn’t apply, you start again at $0.

If looking for ways to save -- now that you have a new deductible to reach -- read 13 ways to save on health insurance.

Last updated: Jun. 11, 2014
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