How Your Health Plan Works: Meeting the Family Deductible
If you are enrolled in an Aetna medical plan and elected coverage for yourself and one or more eligible dependents, you'll want to understand the differences between how the Aetna HSA Plan and Aetna PPO Plan apply expenses toward the annual family deductible.
Aetna Health Savings Plan
- Qualified medical expenses for each family member collectively apply toward the deductible.
- The full family deductible must be met by at least one person before the plan begins to pay.
- After the deductible has been met, the plan will pay for benefits for the rest of the family members for the calendar year.
Aetna PPO
- Each covered person must meet a deductible before the plan pays any benefits.
- If one family member meets the $500 individual deductible, that person's deductible is satisfied and the plan will begin paying that individual's claim.
- The maximum expenses you can count from any one family member is $500, the plan's individual deductible.
- The family deductible is met when any combination of covered family members has expenses totaling the family deductible amount.
- After the deductible is met, the plan will pay for benefits for the rest of the family members for the calendar year.
See examples showing how the family deductible works under each Aetna medical plan option.