How does the deductible work for HealthMate Coast-to-Coast Direct family plans?
The in-network family deductible works in the following way: • Each family member pays for services up to our allowance until two family members separately meet the individual deductible. • Once one family member meets the individual deductible, his or her coinsurance goes into effect for that calendar year. • The rest of the family members will continue to pay for services (up to our allowance) until a second member of the family reaches the individual deductible. At that time, the family deductible is met. • Family members then only pay applicable coinsurance, up to the out-of-pocket maximum. Here’s an example of how the deductible would work for a family of three enrolled in HealthMate Coast-to-Coast Direct Plan 500/1000 when using in-network services: • Sue has a medical procedure that costs $500, so her deductible has been met. She will only have to pay 10 percent coinsurance for in-network healthcare services for the rest of the year, up to the out-of-pocket maximum. • Later that
