Important Rules About How the Deductible Works

All Medical Plan Options

You do not need to meet your medical deductible for in-network preventive care. Due to Health Care Reform, you pay $0 for in-network, age-appropriate services, such as annual physicals and certain cancer screenings.

Options A and B

If you choose Option A or B, you do not need to meet your prescription drug deductible for mail-order medications. You only pay the copay or coinsurance amounts.

Option C

There are two important distinctions regarding how the deductible works for Option C, because it is a Consumer-Driven Health Plan:

  • Combined Medical and Prescription Drug Deductible. For any non-preventive services and prescription drug costs, you must satisfy the full deductible and out-of-pocket maximum before you begin to pay coinsurance. So, if you are prescribed a non-preventive prescription drug early in the year, it is possible that you may have a substantial bill: up to $2,000 (single coverage) or $4,000 (family coverage).
  • True Family Deductible. With Option C, your family’s expenses must meet the full family deductible before the Plan begins to pay coinsurance. Under Options A and B, each individual member of your family need only meet the single deductible for his or her coinsurance to begin. This is called an “embedded” or “individual” deductible. Note that for all options, the out-of-pocket maximums are “embedded” or “individual”. Learn how the family deductible works.
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