What is an ACA Plan deductible?
A deductible is how much you will pay for covered health care services, other than preventative care, before your plan starts to pay. The Benefit Amount(s) the plan would have paid for non-preventive health care services are applied toward your deductible. After you meet your deductible, you will be responsible for expenses over the Benefit Amount, with certain exceptions. Family deductibles are double the deductible for individual family members.
For example, if your primary (individual) deductible is $2,000, your family deductible is met for all family members as soon as $4,000 in total eligible Benefit Amount(s) have applied to deductibles across all your family members. The $4,000 in total eligible Benefit Amount(s) can be met across any combination of at least 2 members on your policy.
Please note: Preventive care is covered at 100% of your plan’s Benefit Amount regardless of whether your deductible is met. Benefit Amounts applied to preventive care are not applied to your deductible. Please see the related FAQ regarding preventive services or contact our Member Care team at 877-653-6440 to learn more about using your Sidecar Health ACA Plan to access preventive care services.