Health insurance deductibles: how do they work?
The deductible is your share of covered expenses. It may apply per year or per event. Some programmes count payments from EOPYY or other insurance towards it. Check the terms; this does not mean every hospital stay will be free.
What exactly is a deductible?
In health insurance, the deductible is the portion of recognized expenses you bear yourself. If your policy has a €1,500 deductible and a hospitalization costs €6,000, the insurer covers €4,500 — provided the expenses fall within the terms and the policy limits.
The deductible is part of the programme's terms. To compare two options, consider both the premium and what you may have to pay yourself.
Annual or per incident — what is the difference?
An annual deductible is calculated over the insurance year. A per-event deductible is calculated separately for each event as defined in the terms. Other co-payments or uncovered expenses may remain after the deductible is met.
The terms may also include tiered versions: e.g. the deductible shrinks or drops to zero when a public fund or another policy is used. This detail dramatically changes the real cost.
How does it combine with EOPYY or a group policy?
Some programmes deduct amounts paid by EOPYY or other insurance from the deductible. Others have different rules. Ask for written confirmation of the payment order and required documents.
If you have group and individual insurance, ask how they work together. Also check when group cover ends if you leave your job.
How much does a higher deductible cut the premium?
There is no universal reduction percentage. Request comparable quotes with different deductibles and otherwise identical cover. This shows the cost difference for your circumstances.
Safety rule: the deductible you choose should be an amount you could pay immediately in an emergency hospitalization without borrowing.
Frequently asked questions
Does the deductible apply to outpatient care too?
Usually not — deductibles typically apply to in-hospital care. Outpatient benefits (doctors, diagnostics) carry their own terms, co-pays, or annual caps.
Can I change the deductible level later?
Lowering a deductible is often treated as an upgrade and may require new underwriting. Raising it is easier. Ask before you sign — rules differ by insurer.
What does “deductible coverage” via a group policy mean?
That whatever your group policy paid counts toward your individual policy's deductible. Check that your individual terms say so explicitly — not all plans do.