Postdeductible

Postdeductible is a term used in health insurance to describe costs that occur after the insured has met the annual deductible. The deductible is the amount a policyholder must pay out of pocket before the insurer starts to share in most covered services. After the deductible is met, many plans require the insured to pay coinsurance (a percentage of the allowed amount) or a fixed copayment for covered services. In some cases, once the deductible is satisfied, certain services may be covered at 100 percent, depending on the plan design.

The postdeductible phase is the period when the insurer begins to pay a portion of costs, but the insured still bears some of the expense through coinsurance or copayments until reaching the plan’s out-of-pocket maximum. The out-of-pocket maximum is the limit beyond which the insurer pays 100 percent of covered services for the remainder of the policy year. Postdeductible costs can include medical visits, tests, procedures, and prescription drugs, though specific coverage and rates vary by plan.

Understanding postdeductible terms requires reviewing the plan’s documents, as some services may be exempt from the deductible or subject to different cost-sharing rules. It is also common for preventive services to have separate coverage terms that may not apply to the deductible in the same way as other care.

See also: deductible, coinsurance, copayment, out-of-pocket maximum.