Deductible

A deductible is the amount of money you have to pay out-of-pocket for covered healthcare services until your insurance company starts to pay. After you meet the deductible, then your carrier starts paying for a portion of your in-network care. You pay for your portion of your care in two ways: either with copays or coinsurance, depending on the type of service. 

For medical plans, you pay nothing for in-network preventive care, regardless of your deductible.

Example: Arya has insomnia, so she decides to go to the doctor to get it checked out.  She has a $500 deductible, which means that she must pay for all of her healthcare expenses until she spends $500. After paying $450 on the doctor's visit and $50 on a prescription, her $500 deductible is met, and her benefits start to kick in.

To find out what your deductible is, log onto your Gusto account and follow these steps:

  1. Click the Benefits tab.
  2. Click on the tile of the benefit you'd like to review.  
  3. If you have a deductible, it will appear in the "What’s Covered" section.
  4. Your deductible will also appear on your Summary of Benefits and Coverage, which you can download by clicking on the "Download full details (PDF)" link.

Note: This article is relevant to companies that have benefits managed by Gusto.  For companies who have benefits managed externally, contact your broker of record for your plan details.