Do I have to pay my deductible first? 

Short answer: It depends on the plan you choose. 

Think of your plan as having two ways to pay: (see example)

The Express Lane (Copays)

How it works for items like a primary doctor visit: 

Plan A (the lowest priced plan)

• You pay the bill. If and when you meet your deductible for the year you only pay 10%

• Ideal if you rarely go to the doctor. 
  
  

Plan B

• You pay a flat fee of $50 and you're done.

• Deductible does not apply. 

• Ideal if you frequently go to the doctor.

The Shopping Cart (Deductibles)

For "big-ticket" items like the ER, hospital stays, or surgery. (example)

• How it works: You might pay the full negotiated price for these services until you hit a certain total—your Deductible. (Some plans have a copay for these services)

• The Goal: Once your "cart" hits that total, your insurance starts sharing the bill with you (Coinsurance).

• The Coinsurance is calculated by the metal level of your plan: Bronze, Silver or Gold

Pro Tip: Look at your Summary of Benefits. If you see a $ dollar sign, it’s likely a flat Copay. If you see a % percentage, you usually have to pay your deductible first.