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.
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Disclaimer
Disclaimer:
The content on this site includes links to tools and information that are not the property of BMC Software, and BMC Software is not responsible for their accuracy, completeness or continued availability. Some of the material contained in this site is based on official plan documents. It is not, nor is it intended to be, the legal plan document or a contract between the company and any employee or contractor. Every effort has been made to ensure the accuracy of this material. In the unlikely event that there is a discrepancy between the site and the official plan documents, the official plan documents will control. BMC Software reserves the right to amend or terminate the plan(s) or program(s) at any time. If you believe the benefits do not describe those available to you, contact the Benefits Center at 877-BMC-4849.
Copyright © BMC Software. All Rights Reserved
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