888-765-5400Deductibles and Out-of-Pocket Amounts?
How do health insurance deductibles and out-of-pocket amounts work?
A deductible is the amount you must pay before the insurance company begins to pay any policy benefits. This is usually an annual amount per insured person, per calendar year. Although typically there will be a maximum amount of deductibles you will have to pay per family in any given year. For example, if your “per person” deductible is $500, and you have five people in your family covered under your health insurance, the maximum “family” deductible is usually three times the individual deductible or $1500.00 in this example. Once three individuals have paid the $500 deductible, no more deductibles will apply to any member of the family for the remainder of the year.
Out-of-Pocket
This is the cost one would pay out of their own pocket. An out of pocket expense can refer to how much the co-payment, coinsurance, or deductible is. Also, when the term annual out-of-pocket maximum is used, that is referring to how much the insured would have to pay for the whole year out of their pocket, excluding premiums.
For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.