Annual Deductibles and Out-of-Pocket Maximums
When choosing a Medical Plan option, it’s important to consider total costs. It’s easy to just look at your paycheck contributions or the deductible amount and make a snap decision. But understanding your estimated total costs under each option is the best way to choose the right plan for your needs.
To do that, you first need to understand how the annual deductibles and out-of-pocket maximums work.
Your annual deductible is the fixed dollar amount you must pay each year toward your medical expenses before the Medical Plan begins to cover a portion of the cost of your health care services. You pay the full cost of services (with some exceptions, shown below) until you meet the total the deductible amount. After the annual deductible is met, you and the Plan share in the cost of services through coinsurance. If the sum of your deductible and out-of-pocket costs reaches the out-of-pocket maximum, the Plan begins to pay 100% of the cost of in-network services and 100% of reasonable and customary cost for out-of-network services for the remainder of the year.
When looking at your three Medical Plan options, the higher the deductible and out-of-pocket maximum, the lower your paycheck contributions will be, and vice versa.