A deductible is a fixed amount of money you have to pay before most, if not all, of your insurance policy's benefits kick in. However, in many health insurance policies, you can use some services, like a visit to the emergency room or a routine doctor's visit, without meeting the deductible first. These services will vary with each type of plan.
An out-of-pocket expense maximum, or cap, is the amount you need to meet for the insurance company to pay 100 percent of your health expenses. Normally, your deductible and coinsurance can be applied toward this maximum amount. Your co-payments or monthly insurance premiums are not included in this cap. Deductible can be separated into individual or family deductibles. A family deductible is typically double the amount of an individual deductible, and it can include several members of an employee’s family. For more information on your plan's specific deductible, contact your HR department, refer to your open enrollment materials, or refer to the plan documents associated with your plan.