How to handle a high health insurance deductible

In the new season of the Netflix comedy-drama, “Beef,” Ashley, played by Cailee Spaeny, lands in the hospital due to an ovarian cyst. The waiting area is bleak, with gray decor and patients who look like they’ve been stranded there for years. Ashley’s partner, Austin, played by Charles Melton, returns from the reception desk with some bad news: “You have a super high deductible — $5,000,” Austin says.

“Oh wow. We can deduct $5,000?” Ashley says. “What if it costs less? Do they give us the difference?”

“It’s kind of the opposite,” Austin replies.

That’s correct — your deductible is the amount you need to pay before your health insurance coverage kicks in. But the Emmy-winning series’ second season, which launched April 16, highlights a common confusion. Just over 1 in 4 Gen Z adults could correctly identify the insurance term “deductible,” according to a 2024 survey from the National Association of Insurance Commissioners.

“Proponents argue that deductibles make people more careful consumers of health care, by avoiding unnecessary care,” said Miriam Straus, associate director at the Center for Health Law and Policy at the O’Neill Institute at Georgetown Law.

“However, many consumers may not realize that, with a high-deductible plan, they can face thousands of dollars in health care costs,” Straus said.

Research shows that unaffordable deductibles can also worsen health outcomes, Straus added. For example, she said, “among cancer patients, high-deductible health plan coverage is associated with worse overall survival.”

In the ’90s and early 2000s, many health insurance plans didn’t even come with a deductible, said Matthew Rae, associate director at KFF, a nonpartisan health policy research organization. Today, that has shifted: Nearly 88% of workers with employer-sponsored insurance have a deductible, up from just 55% in 2006, Rae said.

As medical services expanded and costs surged, employers and insurers turned to deductibles to curb utilization and lower their own expenses. Between 2005 and 2020, Rae said, “we saw a rapid increase in deductibles.” While that growth has slowed recently — largely because employers realized that higher costs could make plans completely inaccessible — that stability may be at risk if the labor market weakens further and cost pressures mount, he added.

“A $5,000 deductible doesn’t surprise me at all,” Rae said.

While some Affordable Care Act Marketplace plans can have deductibles exceeding $7,000, most people pay less. In 2026, the average marketplace deductible is $2,912, compared to $1,881 in 2014.

Meanwhile, those with employer-provided coverage have seen their deductibles jump 17% over the last five years and 43% in the last decade, KFF research shows. Roughly 1 in 5 of these workers now has a deductible of $3,000 or more for single coverage, Rae said.

“Even if it’s not $5,000, that puts a huge financial strain on people,” Rae said. “It’s a shock to your budget.”

There are several ways to figure out your deductible, said Caitlin Donovan, senior director at the National Patient Advocate Foundation.

“It may be on your insurance card, and it could be featured on your explanation of benefits,” Donovan said. “If you have a patient portal, you should be able to log in and find it there, along with how far along you are towards meeting it.”

If you still can’t find it, call your insurance company and ask, she added.

If meeting your deductible seems daunting, keep in mind that “reaching your deductible is not necessarily a goal,” said Katherine Hempstead, senior policy officer at the Robert Wood Johnson Foundation.

Due to protections spelled out in the ACA, certain preventative services with in-network providers should be covered at no charge, whether or not you’ve met your deductible, Hempstead said. There are lists of those protected treatments and tests at Healthcare.gov. Some examples include immunizations, lung cancer screening, birth control and, typically, your annual physical exam.

If you’re young and healthy and rarely use your insurance, you may not need to meet your deductible, Donovan said.

But if, on the other hand, you have a chronic illness or high medical expenses, you may want to hit your deductible early in the year so that, afterward, you can benefit from your coverage, she said. If you can, schedule your most expensive services, like a surgery, after your deductible is paid off and your coverage will be fully in effect, Donovan said.

A high-deductible plan often comes with a health savings account, flexible spending account or a health reimbursement arrangement, she added. All three of these tax-advantaged accounts can make paying for your care a little less burdensome.

“Sometimes, you have to get a little crafty,” she said.

If you haven’t hit your deductible yet and are worried about your upfront costs, do some research before you book a service or exam, said Patricia Kelmar, senior director of health care campaigns at PIRG, a consumer advocacy group.

“Labs and imaging prices can vary tremendously,” Kelmar said. “You can usually get a price in advance from your insurer.”

Try to avoid hospital-based exams because they can lead to facility fees, she added. If you’re offered a discount for paying in cash for a service, it may not count toward your deductible, Kelmar said.

It’s also a smart idea to regularly review the progress you’ve made toward paying down your deductible, Kelmar said. You can often see these details in your insurance provider’s portal.

“Sometimes there are delays if your provider hasn’t yet sent in the claims,” she said. “If you had recent care, check that you received credit for what you paid out of pocket.”