Zane Benefits Discusses “Deductible Nightmares”- A Refresher Course for Insurance Shoppers

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Zane Benefits discusses health insurance terms for American consumers.

In a recent release, Zane Benefits discussed the reality of deductible nightmares. Under the Affordable Care Act (ACA), Americans are mandated to have health insurance coverage. So this means that Americans must health insurance coverage. For many terms like “deductible” and “out-of-pocket maximum” make your eyes glaze over.

In Zane Benefits’ recent release, they define four common health insurance terms that every consumer should know.

The amount paid for covered care before the insurer begins to pay. For example, a family or individual might have to pay $500 out-of-pocket for a covered service like a hospital procedure before the insurance company pays. After the policyholder has paid $500, the insurance company pays the remainder of the cost for the procedure. This would be a $500 deductible.

A set dollar amount paid to the healthcare provider for a covered service. For example, there may be a $30 copayment for each visit to your general practitioner.

The percentage of allowed charges for covered services you are required to pay. For example, if an insurer is responsible for 80 percent of the charges for a service, you would be responsible for the remaining 20 percent.

Out-of-Pocket Maximum:
An out-of-pocket maximum is the maximum amount of money you will pay for covered services during a benefit period (for example, over the course of a year). Let’s start with what your out-of-pocket maximum never includes: your premium, balance-billed charges, or services your health insurance plan doesn’t cover. As for what you’re out-of-pocket maximum does include, that will vary from plan to plan but copayments, deductibles, and coinsurance might be on the list.

According to Zane Benefits, consumer education is key to making the best health insurance decision.

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About Zane Benefits:
Zane Benefits, the #1 Online Health Benefits Solution, was founded in 2006 to revolutionize the way employers provide employee health benefits in America. We empower employees to take control over their own healthcare, while helping employers recruit and retain the best talent. Our online solutions allow small and medium-sized businesses to successfully transition to a health benefits program that creates happier employees, reduces costs and frees up more time to serve their customers. For more information about ZaneHealth, visit

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Leah Bergersen

Leah Bergersen
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