This HDHP plan includes an HSA in which You can contribute pre-tax dollars to use for eligible medical expenses. Each time you visit the doctor or receive health care services, you can use your pre-tax dollars towards the expenses. The HSA covers incurred expenses by paying them from this allocation until the contribution dollars are exhausted.
| HDHP with HSA Information | ||
|---|---|---|
|
You can contribute to your HSA, up to $4,400 for employee only coverage or $8,750 for family coverage. If you are over the age of 55 you can contribute an additional $1,000 catch-up contribution. |
||
| In Network | Out Of Network | |
| General Services | ||
| Annual Deductible/Individual | $7,000 | $14,000 |
| Annual Deductible/Family | $14,000 | $28,000 |
| Annual Out-of-Pocket Limit/Individual | $7,000 | $14,000 |
| Annual Out-of-Pocket Limit/Family | $14,000 | $28,000 |
| You must meet your deductible before the Plan begins to pay for the following services. Until your deductible is satisfied, you are responsible for the full cost of these services, unless otherwise noted in the plan documents. | ||
| Office Services | ||
| Primary Care Physician | 0% After Deductible | 0% After Deductible |
| Specialist | 0% After Deductible | 0% After Deductible |
| Urgent Care | 0% After Deductible | 0% After Deductible |
| Preventative Services | 100% Covered | 100% Covered |
| Hospital Services | ||
| Inpatient Hospital | 0% After Deductible | 0% After Deductible |
| Outpatient Surgery | 0% After Deductible | 0% After Deductible |
| Emergency Room | 0% After Deductible | 0% After Deductible |
Along the way, you may also be required to pay a fixed amount – or copay – each time you see a provider.
