How does my annual deductible and catastrophic cap work?
The annual outpatient deductible begins over again each Jan 1st and is $50.00 per person, no more than $100.00 per family. This deductible must be paid before CHAMPVA will pay 75% of the allowable amount. As claims are processed for covered services, charges are automatically credited to individual and cumulative family deductible requirements for each calendar year. The catastrophic cap (cat cap) begins over again each Jan 1st and is $3000.00 per family per year. Each time we pay a bill, the deductible and cost share (out of pocket expenses) are calculated and credited to the cat cap. When the cat cap reaches 3000.00 for the family, CHAMPVA will then pay at 100% of our allowable amount for the rest of the calendar year.
Related Questions
- If I receive services with a non PPO doctor, do the charges above the PPO allowance apply to my annual deductible or out-of-pocket maximum?
- Can you clarify the difference between the Annual Deductible vs. Out-of-Pocket Maximum in the POS Out-of-Network coverage?
- How does my annual deductible and catastrophic cap work?
