Insured, but deductible is too high?

Want to get healthcare, but your deductible is so high it's like you don't have insurance at all? Pocketero can help.

Expected prices: Average

Patients in this category are usually quoted network-negotiated prices, which are generally around market prices because they are not meaningfully discounted.

The problem

Most people with health insurance have a high deductible. In fact, many people have an extremely high deductible (triple a "high" deductible). This is a problem because insurance won't cover healthcare expenses until the entire deductible has been paid out of pocket. Most people with a high deductible never reach it, so they end up paying out of pocket for all their healthcare. And they do so at mediocre prices, paying more than they need to.

High deductibles are already the norm, and becoming more common every year. In 2022, the IRS defined a "high deductible health plan" (HDHP) as "any plan with a deductible of at least $1,400 for an individual or $2,800 for a family." Based on that rule, the majority of individual and family policies qualify as high deductible plans.

The IRS definition isn't sufficient. Many plans have significantly higher deductibles. We might define an "extremely high deductible health plan" as being triple the IRS threshold, meaning $4,200 for an individual or $8,400 for a family. It is common to see deductibles that exceed even these extreme thresholds. There are probably millions of individuals with a deductible of $5,000 or more, and millions of families with a deductible of $10,000 or more.

Most people with a high deductible will not reach it in a given year. When paying out of pocket, they will usually be quoted prices negotiated by their insurer. These negotiated prices are better than full "chargemaster" prices, which are deliberately inflated. But these negotiated prices are still generally mediocre - they are far from the best prices.

The solution

Pocketero empowers you with the best prices when paying out of pocket. For a very low membership fee, you can get prices that are around half of insurance-negotiated prices, without restrictions on providers, drugs, or services.