Health insurance 101
Which expenses count toward your deductible?

Blue Cross of Idaho
A deductible is the amount of money you are responsible to pay out-of-pocket before your policy begins to pay benefits for covered services. The money you spend toward your yearly deductible is known as "out-of-pocket," because you are responsible for those expenses. The specific expenses that apply depend on your policy. They may include:

  • Physician visits
  • Physical therapy visits
  • Hospital visits
  • Prescription medications
  • Medical devices and equipment
  • Lab tests

Your health insurance policy will cover some expenses completely, even if you haven't reached your deductible yet. Examples of these may be routine physicals and flu shots.

Expenses that don't count toward your deductible include your monthly premiums and common health-related purchases such as over-the-counter painkillers or contact lens solution. There are also some expenses that you will have to pay for even once you have reached your deductible, such as out-of-network healthcare services and certain prescriptions or treatments that are not covered by your plan.

Everyday example:
Lori chose a plan with a deductible of $1,000. She suffered an accident that cost $1,250 to treat. Lori was responsible for the first $1,000, meeting her deductible for the year. Then her insurance policy covered the remaining $250.

What's your current balance towards your deductible? Log in to your account at, click on "Claims, EOBs & Coverage Descriptions," and then click on "Deductible & Maximums" to see how much you've spent towards your deductible.

Published 12-13-13