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Your UMP CDHP deductible is $1,400 per person every calendar year ($2,800 for accounts with more than one person). For most covered services, you pay toward the deductible before the plan begins to pay.
Prescription drugs count toward your deductible. You pay the entire cost for drugs, even those covered by the plan, until you meet your entire deductible. The deductible applies no matter where you purchase your prescription.
The following out-of-pocket expenses do not count toward your deductible:
- Services you pay for that aren't covered by the plan (including noncovered drugs).
- Services exempt from the deductible, even if you had out-of-pocket costs. For example, preventive care received from an out-of-network provider.
- Charges for services above benefit maximums. For example, the maximum for adult vision hardware is $150 every two calendar years. Charges over $150 for vision hardware do not count toward your deductible.
- Charges for services beyond benefit limits*. For example, the annual benefit limit for acupuncture is 16 visits. Costs for more than 16 visits are not covered by the plan and do not count toward your deductible.
- Out-of-network provider charges that exceed the allowed amount, including non-network pharmacies.
The plan pays for these services and drugs (subject to your coinsurance) even if you haven't yet paid your deductible.
- Preventive care and immunizations.
- Routine vision care (exams, glasses, and contacts).
- Select contraceptive supplies and services for women.
- Certain products available from network pharmacies.
- Diabetes Prevention Program.
- Tobacco cessation services.
- If you cover only yourself, your deductible is $1,400. You must pay this amount for covered services not exempt from the deductible (including covered drugs) before the plan begins to pay for your care.
- If you cover yourself and at least one other person, your deductible is $2,800. You must pay this amount for covered services for all covered persons combined before the plan pays for any services, including drugs (other than those exempt from the deductible).
*Benefit limits: If you receive services with a benefit limit (such as spinal manipulation, massage therapy, or physical therapy) before meeting your deductible, those visits will count toward the benefit limit. For example, if you pay out-of-pocket for a chiropractor visit because you haven't met your deductible, that visit will count toward the maximum of 10 visits per calendar year.
Note: If a dependent has other primary coverage, visits paid by the primary plan also count toward UMP CDHP benefit limits.