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View Diary: ACA: Understanding the details: Deducing the deductible; something you DO need to think about (65 comments)

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  •  Out of pocket (6+ / 0-)

    The deductible is what you have to pay before the insurance company pays anything. The way it normally works is that after that, the insurance company pays some percentage, then once you hit your out of pocket maximum, you pay nothing.

    My deductible is $1750, so I have to pay that amount before the insurance company pays anything (other than the no-deductible items such as a check-up). After that, the insurance pays 80% of most items until I've paid an additional $1750 (20% of $8750). From that point, insurance pays 100%.

    •  Thanks (3+ / 0-)
      Recommended by:
      worldlotus, yella dawg, ladybug53

      That makes a lot more sense than what the agent told me.

      I'm finding out that insurance agents don't necessarily know their products, because I was in a car accident last week, and my agent told me the towing wasn't covered because I hadn't purchased their extra towing coverage (since I have AAA, it seemed redundant). So I paid $72 out of my pocket for the extra mileage over the 5 miles AAA gives you to have it towed back to a place in my hometown that I knew I could trust.

      But then when the claims dept. called me, they told me towing after an accident fell under my collision coverage, and not only that, they will have it towed to the repair shop of your choice (in other words, no mileage limit). So now I have to fax them my receipt to get reimbursed. You'd think my agent would have known this!

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