13 of 33 Before You Go How You Pay for Care Special Programs and Services Learn More Annual Deductible The annual in-network 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 amounts for the PPO Plan are: • Associate Only: $1,000 • Family: $2,000 The PPO Plan has an embedded deductible, which is an important concept to understand if you are covering dependents. This means once a covered family member meets the individual deductible, the plan begins sharing in-network costs with you for that family member. Charges for all covered family members will continue to count toward the family deductible. Once the family deductible is met, the plans share costs with you for all covered family members. Note: The annual deductible for out-of-network benefits under the PPO Plan is higher than the annual in-network 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., $20 copay for a Teladoc visit) • Premiums deducted from your paycheck
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