Anyone who knows about Health Insurance deductables .. please answer .. ???

Question

My husband, son and I are on the same Blue Cross PPO plan.

(we have a SHARED $2,500 DEDUCTABLE)

Our son is 7 and a half months old, and before he was born we had a $1,500 deductable which was met when I delivered him.

(pre-natal appts. and delivery made me meet the deductable)

anyway, when he was born, we immediately (within 2 weeks) switched the deductable to $2,500 and added him onto the policy. By doing that, we instantly went back to $0 met towards our deductable. With Blue Cross whenever you change your policy, you automatically start back at $0.

So, now, my husband just had his appendix out .. which means we met our deductable again.

Does that mean we ALL have our deductables met? since we have a shared PPO plan? a shared deductable.

Does that mean our sons co-pays will also be drastically lower?

or just my husbands, because he had the surgery?

Answer 1

IF this is a true shared or family deductible, then when your husband's surgery met the deductible, it satisfied it for the entire family.  Check with your agent, company HR person or the insurance claims department to get a final determination.

There is a difference between deductibles, co-insurance and co-pays.  If you don't understand these differences, talk to someone who represents the plan you have and ask them to explain these terms to you.  Meeting your deductible and satisfying your maximum out of pocket co-insurance, does not change your co-pays.  Once you understand these terms, you will understand how the policy pays.

Answer 2

if its a shared deductible it is one deductable for all people on the policy, so if you paid $2,500 then its been met and there should be no further until the policy renewal date .  You may still have a copay amount but it should be fairly low .