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Some deductibles and out-of-pocket maximums start over in January


As another year comes to an end, it’s important to remember that most medical and prescription drug deductibles will restart on January 1.

In addition, coinsurance and total out-of-pocket maximums start over with the new year.

What is a deductible?

  • A medical deductible is the amount you pay for health care before your medical insurance begins to pay for any of your benefits.
  • A prescription drug deductible is the amount you pay for drugs before your prescription drug insurance pays any benefits.
What is an out-of-pocket maximum?
  • The coinsurance out-of-pocket maximum is the most you’ll pay in coinsurance during the year for certain health care services, such as lab tests, x-rays and physical therapy. This does not include deductibles or copays.
  • The total out-of-pocket maximum is the most you’ll pay during the year for any in-network health costs including coinsurance, copays, covered health care and prescription drugs. If you reach the out-of-pocket maximum, the plan pays 100% of your covered in-network health and prescription costs for the rest of the year.

 Click here to read the full article on the ERS Website.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

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