Important Questions Answers Why This Matters
What is the overall deductible? In-network: Individual $6,850 / Family $13,700. Out-of-network: Individual $13,700 / Family $27,400. Does not apply to certain office visits, preventive care and urgent care in-network. You must pay all the costs up to the deductible amount before this plan begins to pay for covered services you use. Check your policy or plan document to see when the deductible starts over (usually, but not always, January 1st). See the chart starting on page 2 for how much you pay for covered services after you meet the deductible.
Are there other deductibles for specific services? No. You don’t have to meet deductibles for specific services, but see the chart starting on page 2 for other costs for services this plan covers.
Parts A & B
Services Medicare Pays After you pay $2200 deductible*** plan pays In addition to $2200 deductible*** plan pays
Home Health Care - Medicare Approved Services
Medically necessary skilled care services and medical supplies 100% $0 $0
Durable medical equipment
First $183 of Medicare Approved amounts*
$0 $183 (Part B Deductible) $0
Remainder of Medicare Approved amounts 80% 20% $0