What is a deductible in health insurance?

A deductible is the first slice of a medical bill that you pay yourself. The insurer picks up eligible costs above it. Cigna Global states the same thing on its own plans-in-detail page, checked 11 August 2026: "A deductible is the amount which you must pay before any claims are covered by your plan."

You will also see it called an excess, which is the more common word in British policies and means the same thing. The word matters less than the number and the reset rule attached to it.

Everything below is about how private and international health policies use the term. If you are American, note that this is not the US Affordable Care Act structure with an out-of-pocket maximum sitting behind the deductible. International plans mostly cap what they pay through benefit limits, not what you pay through an out-of-pocket ceiling, so a deductible here behaves differently from the one on a US employer plan.

This is the difference that changes the bill, and it is almost never on the marketing page.

• An annual deductible applies once per policy year across everything you claim. You pay it down over the year and then the plan pays in full up to its limits.
• A per-claim, per-condition deductible resets. Two unrelated conditions in the same year mean paying it twice.

Both structures are live in this market. Cigna Global's published wording is plan-level: the deductible is what you pay "before any claims are covered by your plan". The policy wording behind the plans we arrange runs the other way, excluding "any excess, deductible or co-insurance per benefit per condition per year", which is a per-benefit and per-condition structure.

When you compare two quotes with the same deductible figure on them, this is the sentence you are really comparing. Ask the insurer to confirm in writing which of the two applies to you.

Three separate mechanisms, often used loosely as if they were one.

• Deductible or excess: a fixed amount you pay before the insurer pays.
• Co-insurance: a percentage of each eligible claim that stays yours. Cigna Global publishes cost-share options of 0%, 10%, 20% and 30% on its plans-in-detail page.
• Co-pay: a flat fee per visit or per prescription.

A policy can carry more than one at once. On the plans we arrange, the Comprehensive tier applies 25% co-insurance to annual medical check-ups, vaccinations and major dental, and the wording is explicit that where more than one co-insurance rate could apply to a claim, the higher rate prevails. Co-insurance also reduces the benefit limit, not just the payment, which is the part people miss.

The trade is simple and the insurers say so themselves. Allianz Care's international healthcare plans page, checked 11 August 2026, describes choosing a core plan and an optional deductible, and says that opting for an out-patient deductible lets you "enjoy reduced premiums". Cigna Global publishes a deductible ladder of $0, $375, $750, $1,500, $3,000, $7,500 and $10,000 on its plans-in-detail page, and a separate cost-share choice on top of it.

Two ladders, then: how much risk you keep, and how much cover you buy. The plans we arrange only move the second one. There is no menu of deductible options in the wording; excess and co-insurance amounts are whatever is specified on your certificate of insurance. The lever you pull is the tier, from $392 for Essential Health to $1,906 for Fully Comprehensive at adult age 18 in the EU region, billed annually.

Which approach suits you depends on your cash position. A large deductible is a real saving only if you can absorb it in a bad year without borrowing. If you cannot, the cheaper premium is a loan you have taken out against your own health.

There is no single market range, and anyone who quotes you one is generalising. What we can report is what individual insurers publish on their own pages, checked 11 August 2026.

• Cigna Global publishes seven deductible steps from $0 to $10,000, applied across its plan options.
• Allianz Care publishes an optional deductible on the core plan and a separate out-patient deductible, without naming amounts on that page.
• IMG Global states on its international health insurance page that its Global Medical Insurance lets you choose from several plan options, areas of coverage and "multiple deductibles", again without listing them there.

We could not read published plan detail for Bupa Global, Aetna International, April International, GeoBlue, Now Health or AXA on that date, because their sites did not return usable content to us. We are not going to fill that gap with an estimate.

On the plans we arrange, the word deductible carries a specific meaning that is easy to miss. It is the amount deducted from your reimbursement when you are treated outside the direct settlement network.

Inside the network the mechanic is different again: once planned treatment is pre-authorised, the insurer settles with the hospital directly and you do not pay and reclaim. Go outside it and you pay first, claim after, and the deduction applies. If you already know which clinic you want to use, that is a question worth asking before you buy rather than after your first admission.

It can, and this is the one place where the number on your certificate is not just about money. France commonly refuses policies carrying a deductible on the core cover, and Italy commonly expects zero deductible in the first year of an elective residence visa.

We keep the detail on one page rather than two: read the no-deductible rule for France and Italy visa insurance for the country rules and for how to spot a deductible clause on a certificate before you submit it. Then compare what each tier buys.