What are the Plan’s medical deductible and out-of-pocket maximum amounts?
Each year the Plan covers a portion of eligible expenses after you satisfy the calendar year deductible. The calendar year deductibles are: • In-network: $250 per person; $750 per family • Out-of-network: $500 per person; $1,500 per family Charges applied to the in-network deductible will also apply to the out-of-network deductible and vice versa. In addition, once you reach the out-of-pocket maximum, the Plan covers 100% of eligible expenses for the remainder of the calendar year. The out-of-pocket maximums are: • In-network: $3,500 per family including the deductible • Out-of-network: $7,000 per family including the deducible (For non-Medicare retirees: In-network: $1,750 per person; Out-of-network: $3,500 per person.) The out-of-pocket maximum includes the deducible expense. Amounts applied to the in-network out-of-pocket maximum will also apply to the out-of-network out-of-pocket maximum and vice versa. For a summary of medical benefit coverage, refer to Medical Benefits.
Related Questions
- Are amounts incurred by an individual for medical care before a health plan’s deductible is satisfied included in computing the plan’s out-of-pocket expenses under section 223(c)(2)(A)?
- What medical services count toward the maximum out-of-pocket expense in the Aetna Choice POSIIHRA plan?
- Does the copayment apply to the deductible in the POS plan, as well as to the Out-of-Pocket maximum?
