What covered services will the employee have to pay for out of his/her own pocket?
• The employee has used all of the HCA funds, but has not yet met the deductible. The employee is responsible for paying for health care services until the deductible is satisfied. • The employee has met the deductible, so PPO benefits are available. If the plan includes coinsurance, the employee will be responsible for paying a percentage of the charges. There is an out-of-pocket maximum, so the employee won’t pay more than this amount during the benefit year as long as he/she stays in network. The employee can check the plan documents for specific coverage details. • Non-covered services, additional coinsurance (until the employee meets the higher out-of-pocket limit), and charges in excess of our allowed amount when the employee receives services out of network.
Related Questions
- If the employee’s family is not covered under the employees’ qualified HDHP, can the employee still use his or her HSA funds to pay their qualified expenses?
- Do CEP students receive the services that are covered by the matriculation fee, even though they don pay that fee?
- What covered services will the employee have to pay for out of his/her own pocket?
