This is the amount you pay before your insurance begins picking up any of the costs for certain services during the year.
Log in to MyBlue after your effective date to see how much you've spent toward your deductible.
Your deductible is $250 per member (or $750 per family).
This is the most you pay per plan year for covered health expenses before the plan pays 100 percent of covered expenses for the rest of the year.
Log in to MyBlue to see how much you've spent toward your out-of-pocket maximum.
Your in-network out-of-pocket maximum is $5,000 per member (or $10,000 per family) for PCP/plan-approved and self-referred combined.
A copayment is the cost you're required to pay for certain services or prescription drugs.
Doctor's office visit: $15 per visit
Specialist visit: $25 per visit
Emergency room: $75 per visit (waived if admitted or for observation stay)
Prescription drugs: $10–401
1. Cost share waived for Tier 1 birth control.
Co-insurance is the percentage of costs that you pay, or "share," for most self-referred major medical benefits.
Your co-insurance is 20 percent after your deductible for self-referred major medical benefits.
Active Employees & non-Medicare eligible Retirees
