How does the "family" deductible work? (HSA, medical, plan)
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I understand the Individual deductible but not clear on how you reach a family deductible.
For ex. wife, kid and myself would need to reach $6000 of combined medical expenses to meet the family deductible?
That is correct. Some plans allow for members to hit their individual deductible and those members be covered, but more and more require the entire family deductible to be hit before offering any coverage.
For ACA compliant plans, if the family OOP maximum is more than $6,850 in 2016 ($7,150 in 2017), then the plan must include an embedded individual OOPM.
Quote:
Q. When I compare health insurance plans in the exchange for our family, they all show total family deductibles and out-of-pocket maximums (OOPMs). Does that mean we’d have to meet the full family out-of-pocket limit, even for just one person?
A. As of 2016, no.
Prior to 2016, family plans could have aggregate OOPMs. Starting in 2016 (for plans that are not grandfathered or grandmothered), no individual can be required to pay more than the individual out-of-pocket maximum, even if the individual is enrolled in a family health insurance plan.
For 2016, the individual OOPM is $6,850, and the family OOPM is $13,700 (these are increasing to $7,150 and $14,300 in 2017). Under the new rules, no single member of a family can be required to pay more than $6,850 in out-of-pocket charges in 2016, regardless of whether the rest of the family has incurred any claims. This includes people enrolled in family HDHPs, and HHS has clarified that this does not conflict with HSA and HDHP requirements.
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