Once you have paid the deductible during the policy year, the insurance company will pay for covered medical expenses for the rest of the policy year in accordance with the terms of the policy. Under a per occurrence deductible, you must pay the deductible amount for each separate sickness or injury. If you have five claims in one year, you would have to pay the deductible five times. The insurance company will pay its share of any additional expense. These state the types of injuries or illnesses that are not covered.
All policies have exclusions.
Injuries resulting from some specific activities may also be excluded. For example, if you plan to drive a car or snow ski, these activities may be excluded. Never assume you will always be covered. Check the exclusions before you purchase insurance. If you do not use the medical services from the HMO to which you belong, you will have to pay for your medical care.