Deductible and Co-Insurance
The deductible is $350 per person, per Plan year for In-Network Charges / $700 per person, per Plan year for Out-of-Network Charges.
After the deductible is met, Benefits will be paid at 80% of the Maximum Allowable for services rendered by Preferred Providers in the Cigna Network. Services obtained by Out-of-Network providers (any provider outside the Cigna Network) will be paid at 50% of Usual and Customary Charges.
The deductible will be taken from the first bills submitted to the insurance for covered expenses. The deductible may be met with charges from a combination of providers: physicians, hospital, lab, etc.
Maximum Payment for You and for Each Dependent
Claims for a covered Injury or sickness will be limited to a policy aggregate maximum of $500,000 per policy year.
Total Family Deductible
The total deductible for a family shall be three individual deductibles.
Carryover of Deductible
If during the last 90 days of the plan year, an insured person incurs eligible expenses which were applied to his or her deductible, such expenses will also be applied to his or her deductible for the following plan year.