The plan deductible is the amount that you pay during a calendar year before the health
plan "kicks in" to reimburse for medical expenses. Some plans may pay certain benefits
before the deductible is satisfied, for example office visits may be covered with a
copayment. Some plans may have additional deductible for certain expenses, a common
example is an additional deductible for prescription drugs. In general, the subscriber must pay
the deductible amount before the plan reimburses for covered medical expenses.
Below are various family deductible arrangements.
|Embedded deductible||Under this arrangement, the family deductible is stated as a dollar amount. If any family member reaches the individual deductible then the deductible is satisfied for that family member. If any combination of family members reach the family deductible, then the deductible is satisfied for the entire family.|
|Common deductible||For persons who do not cover dependents, the single deductible applies. For persons who cover dependents, there is no single deductible involved. Expenses for all family members accrue toward the family deductible. The family as a whole must satisfy the deductible before medical expenses are reimbursed.|
|Per person deductible||Each family member must satisfy the deductible amount in full before coverage begins for that family member.|
|Deductibles per family||Per family deductibles are described as "2 per family" or "3 per family". Under this arrangement, if the designated number of family members meet the deductible in full then the deductible is deemed satisfied for all family members.|