Question

Once Mary's yearly health expenses are greater than $1,000 her insurance company starts footing the bill (or part of the bill). She has an out of pocket limit of $10,000. How much must Mary pay before her insurance company begins paying the bill?

Answer 1

Deductibles and out of pocket money are different things. Deductibles are the money that you need to pay before your insurance starts to pay your medical bills. Generally once you have reached your total deductible per year, the insurance company will start paying but you will still have to pay for a certain amount of the expenses (e.g. 20%).

But if your medical bills are too high, then after you have paid $10,000 (deductible + $9,000), your insurance company will not require that you pay any percentage f the bill, they will pay the invoice completely.

So the company will start paying after $1,000, but Mary will pay a % until her share of the costs reaches $10,000, and after that she will not pay any more.