Are the in-network deductible and coinsurance accumulated separately from the out-of-network deductible and coinsurance?
In most cases, the answer is yes. The in-network accumulators and out-of-network accumulators are separate. This means that if a Member meets their in-network deductible, there is an incentive to continue to receive care in-network. Please note: NJ small group in-and-out-of-network deductibles and coinsurance charge limits are combined.
Related Questions
- Why is the HMO Only plan coinsurance 20% when the Options Low Deductible plan in-network coinsurance is 10%?
- How does medical deductible work when an employee has a mix of in-network and out-of-network providers?
- How does the medical deductible work if I have a mix of in-network and out-of-network providers?
