Deductibles & Out-of-Pocket Expenses

The Out-of-Pocket Expense chart summarizes the co-pays, co-insurance and deductible you may be responsible for.

Deductibles & Out-of-Pocket Expenses 

The types of expenses are defined as follows:

  • Co-payment:  a dollar amount that you are required to pay at the time services are rendered.
  • Co-insurance:  the percentage the member is responsible for when coverage is less than 100%.
  • Deductible:  an amount, usually stated in dollars, for which you are responsible each benefit period before the third party administrator will start to reimburse benefits.

Note:  Retirees who have Medicare Part B as their primary health plan (age 65 and older) are not subject to the co-payment when the RHP pays as secondary.  However, for services not covered by Medicare and the service is a covered benefit by the RHP, the RHP then pays as primary.  In this instance, you could be responsible for the applicable co-payment.

The out-of-pocket expenses chart summarizes the different costs based on the plan selected.