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

12/29/2018

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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