Understanding ICUBA's Medical Plan Deductibles

ICUBA's medical plan year begins April 1 and ends March 31 of the following year. The deductible and out-of-pocket maximum for ICUBA's medical plans reset every plan year on April 1.

When 1 or 2 members are covered under a medical plan, each member will be responsible for an individual deductible and out-of-pocket maximum.

• $3,000 deductible & $6,000 out-of-pocket maximum in the Preferred plan.

• $4,500 deductible & $7,200 out-of-pocket maximum in the High-Deductible plan.

When a family (two or more members) is enrolled in a medical plan, all the family members share the family deductible and out-of-pocket maximum. Once any combination of family members satisfies the family deductible and out-of-pocket maximum, no one else in the family is required to pay toward those expenses.

• $6,000 deductible & $12,000 out-of-pocket maximum in the Preferred plan.

• $7,200 deductible & $14,400 out-of-pocket maximum in the High-Deductible plan.

  
  

It is important to remember, there are separate deductibles and out-of-pocket maximums for out-of-network services! Refer to your Summary of Benefits and Coverage for more information. Deductible and Out-of-Pocket maximums reset each year on April 1st.

Example 1:

A family of four are enrolled in the Preferred PPO Plan🧑‍🦰🧑‍🦱🧑‍🦳🧑‍🦲

🧑‍🦰satisfied $3,000

🧑‍🦳satisfied $3,000

That's $6,000 and the family deductible is met, now all family members move to coinsurance.

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Example 2:

A family of five are enrolled in the Preferred PPO plan 🧑‍🦰🧑‍🦱🧑‍🦳👦👧

🧑‍🦰satisfied $3,000 

🧑‍🦱satisfied $2,000 

👧satisfied $1,000 

That’s $6,000 total and the family deductible is met, now all family members move to coinsurance.

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Example 3: 

A single parent expecting a baby is enrolled in the Preferred PPO plan 🤰 

🤰satisfied $3,000 before the baby is born.

Once the👶is born and added to the plan, the baby will have an individual deductible of $3,000 effective their date of birth.

Since there are 2 members covered under the plan, and 🤰satisfied $3,000, the👶 will have to satisfy an individual deductible of $3,000 for the remainder of the plan year.

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Example 4:

Parents A & B are expecting a baby and enrolled in the Preferred PPO plan 🧑‍🦰🧑‍🦱

🧑‍🦰satisfies $3,000 before the baby is born.

🧑‍🦱satisfied $1,000 before the baby is born.

That's $4,000, the remaining $2,000 becomes part of the family deductible once the 👶 is born and added to the plan.

Since 🧑‍🦰satisfied $3,000 and 🧑‍🦱satisfied $1,000, the remaining $2,000 will now be shared as the family deductible by 🧑‍🦱and 👶.

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