IQVIA Benefits Handbook
DEDUCTIBLE
Deductible
The deductible is the amount you pay each year for eligible medical expenses before the plan begins to pay for certain benefits.
The deductible is the amount of covered charges you pay each year before the plan begins paying benefits. Exceptions include in-network preventive care and in-network physician office visits ($400 Deductible PPO Plan and $900 Deductible PPO Plan).
Only covered services count toward the deductible. This includes Maximum Reimbursable Charges (MRC) for medically necessary services out-of-network. Amounts above MRC limits are not covered services and do not count toward your deductible.
The annual deductible for each option is shown below:
Coverage Type
$400 Deductible
PPO Plan
$900 Deductible PPO Plan
$1,850 Deductible
Plan with HSA
$2,850 Deductible
Plan with HSA
 
In-Network
Out-of-Network
In-Network
Out-of-Network
In-Network
Out-of-Network
In-Network
Out-of-Network
  • Individual
  • $400
  • $2,500
  • $900
  • $3,000
  • $1,850
  • $3,700
  • $2,850
  • $5,700
  • Family
  • $800
  • $5,000
  • $1,800
  • $6,000
  • $3,700
  • $7,400
  • $5,700
  • $11,400
  • In the $1,850 Deductible Plan with HSA administered by Aetna, if you cover dependents, you and your covered family members must meet the family deductible before the plan pays benefits for any family member. Medical and prescription drug expenses for one family member or for all family members can add up to the deductible.
  • If you enroll in the $1,850 Deductible Plan with HSA administered by Kaiser or $2,850 Deductible Plan with HSA administered by Aetna or Kaiser, each individual only needs to meet the individual deductible before the plan pays benefits for that individual member.