An Individual Deductible: If you are the only person on your plan, you only have to reach the individual deductible and the family deductible listed on your Summary of Benefits does not apply to you. This amount, when applicable, must be satisfied by you each benefit period before any payment will be made by us.
A Family Deductible: If you have one or more family members on your plan, the family deductible can be satisfied by any one covered person or a combination of covered persons as follows:
If your Summary of Benefits indicates that the deductible is embedded, each covered person only needs to satisfy the individual deductible and not the entire family deductible, prior to us paying for covered services for that covered person. We will not begin to pay for covered services for the other family members until they either satisfy the individual deductible or until the family deductible is met. The family deductible is met when any combination of family members‟ costs for covered services meets the family deductible limit. The maximum amount that any one covered person in your family can contribute toward the family deductible is the amount applied toward that person’s individual deductible.
This material is for informational purposes only and is subject to change. Please refer to your Policy Terms and Conditions for a complete description of the benefits, conditions, limitations and exclusions of coverage. Products and services may not be available in all jurisdictions and are expressly excluded where prohibited by applicable law.