Once you’ve met your health insurance deductible, your insurance company typically starts paying most of your covered health care expenses, while you may still owe copays or coinsurance until you reach your out‑of‑pocket maximum.

How payment works after the deductible

  • After the deductible is met, the health plan begins sharing costs instead of you paying 100% of covered services.
  • You usually keep paying your monthly premium, plus smaller amounts like copays (flat fees) or coinsurance (a percentage of the bill).
  • Once you hit your plan’s out‑of‑pocket maximum, the insurance generally pays 100% of covered in‑network services for the rest of the year.

Who “typically” pays

  • For covered, in‑network care after the deductible, the insurer usually pays the larger portion of each bill (for example, 70–80%), and you pay the rest as coinsurance.
  • Some plans have no coinsurance after the deductible for in‑network services, meaning insurance covers 100% of allowed charges once the deductible is met.

Important exceptions

  • If you use out‑of‑network providers, your share can be higher, and you may owe any amount above what the plan considers an “allowed” charge.
  • Services not covered by your plan are your responsibility even if you’ve met your deductible and out‑of‑pocket maximum.

Simple takeaway

  • Before the deductible: you pay most covered costs (besides preventive care, if your plan covers that at no cost).
  • After the deductible: your insurance typically pays most of the covered costs, and you pay copays/coinsurance until the out‑of‑pocket maximum is reached.

Information gathered from public forums or data available on the internet and portrayed here.