14 of 39 Before You Go How You Pay for Care Special Programs and Services Learn More Annual Deductible The annual deductible is the amount you pay out of your own pocket for covered medical services before the plan begins to pay benefits. The annual in-network deductible for the HSA Plan is: • Associate Only: $2,000 • Family: $4,000 The HSA Plan has an aggregate deductible, which is an important concept to understand if you are covering dependents. This means that the entire family deductible must be met before the plan shares costs with you for any covered family member. In other words, once the aggregate family deductible has been met, health insurance coverage kicks in for the entire family. There are two ways the aggregate deductible can be met: 1. As each member of the family uses and pays for healthcare services, the amount paid out-of-pocket for those services is credited toward the family’s aggregate deductible. After several family members have paid deductible expenses and the combined total of those in-network expenses reaches $4,000, the health plan then begins to share the cost of in-network healthcare expenses for all members of the family. 2. One member of the family has high healthcare expenses. The amount they pay out-of-pocket for those in-network expenses reaches $4,000. The health plan then begins to share the in-network healthcare expenses of the entire family, even though only one family member has paid anything toward the aggregate deductible. Note: The annual deductible for out-of-network benefits under the HSA Plan is higher than the in-network annual deductible. Know When Your Deductible Applies Your health insurance deductible and monthly premiums are probably your two largest healthcare expenses. Because your deductible counts for the lion’s share of your healthcare spending budget, understanding what counts toward your deductible and what doesn’t is important. Before your annual deductible is met, you pay for 100% of your medical bills, except for copays (e.g., $10 for a retail Generic prescription) and preventive care (always covered at no cost to you). After the deductible has been met, you pay only coinsurance or copayments (depending on the type of care or service) until you meet the out-of-pocket maximum (see “Out-of-Pocket Maximum” on the next page). What does not count toward the annual in-network deductible? There are a few healthcare expenses that do not count toward the deductible: • H ealthcare services not covered by the plan (e.g., cosmetic surgery for facial wrinkles) • Out-of-network care • Copayments (e.g., $10 copay for a retail Generic prescription) • Premiums deducted from your paycheck
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