Understanding California Health Plan Deductibles

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First, the official definition:

Deductible

The amount you must pay for medical services each year before your insurance begins paying.

Now what does that mean?

The deductible is an amount you will pay first before you get help from the carrier. Keep in mind that with a PPO plan, you will get discounted PPO rates which can lower the costs by 30%-60% even though you have a deductible to meet. It’s very important to always stay in-network to keep your costs down.

Exceptions to deductibles. Most traditional plans on the market allow copays for office visits and prescription before you meet your deductible. For example, if there is a $40 copay for office visit, you will pay the $40 right away rather than having to pay the full doctor visit subject to the deductible.

Prescription coverage is frequently broken out separately from the main deductible. There may be a separate deductible from Brand name drugs. This means that with a $250 brand deductible and $30 brand copays, you would pay the first (resets each Jan 1st) $250 of your drug costs and then you would get $30 copays afterward. The brand RX deductibles on the California...

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