How does a calendar-year deductible affect claims?

How does a calendar-year deductible affect claims?

• A. it's always paid by insurer
• B. it applies per policy period
• C. it always applies to every visit
• D. it resets annually

Answer: (D)

A calendar-year deductible means you must pay your covered medical expenses out of pocket up to a specified amount within a single calendar year before the insurer starts paying according to the plan. It isn’t tied to visits or to a different policy period; the amount you pay toward the deductible accumulates across all eligible claims in that year. At the start of the next year, the deductible resets to zero, and you begin meeting a new year’s deductible again. So, early in the year you may pay most costs yourself until you reach the deductible, after which the plan generally pays according to its coinsurance and benefits until you hit the out-of-pocket maximum.

A calendar-year deductible means you must pay your covered medical expenses out of pocket up to a specified amount within a single calendar year before the insurer starts paying according to the plan. It isn’t tied to visits or to a different policy period; the amount you pay toward the deductible accumulates across all eligible claims in that year. At the start of the next year, the deductible resets to zero, and you begin meeting a new year’s deductible again. So, early in the year you may pay most costs yourself until you reach the deductible, after which the plan generally pays according to its coinsurance and benefits until you hit the out-of-pocket maximum.