What happens once the deductible is met in an insurance plan?

Once the deductible is met in an insurance plan, the typical process involves the application of coinsurance fees to covered services. This means that after an individual has paid their deductible, the insurer begins to share the costs of covered healthcare services with the insured. Generally, the insured might be responsible for a certain percentage of the costs (the coinsurance), while the insurer covers the remaining percentage.

For example, if a plan has a 20% coinsurance, after the deductible has been satisfied, the insured would pay 20% of subsequent medical bills, while the insurance company pays the remaining 80%. This structure allows for shared financial responsibility between the insurer and the insured, promoting use of healthcare while still encouraging members to consider costs.

In contrast, the other responses describe scenarios that do not accurately reflect what happens after a deductible is met. For instance, while it might sound appealing to think that insurers would pay 100% without stipulations, most insurance policies incorporate some form of cost-sharing through coinsurance after the deductible. Similarly, the suggestion that the insured pays no further costs or that only minor services are covered fails to capture the standard practices in insurance plans, where specific cost-sharing mechanisms like coinsurance are detailed.