Annual Deductible means the amount, which the patient must pay each calendar year for covered expenses before the Fund becomes liable for its share of such expenses.
Annual Deductible. Amount: $0 Formulary Type: Comprehensive+ Number of Cost Share Tiers: 4 Tier Initial Coverage Limit: $4,660 True Out‑of‑Pocket Amount: $7,400 Maximum Out‑of‑Pocket Amount $1,500 Once your individual out‑of‑pocket expenses reach this amount, you will pay $0 for all covered prescription drugs for the remainder of the plan year. Retail Pharmacy Network: P1 The name of your pharmacy network is listed above. The Aetna Medicare pharmacy network includes pharmacies that offer standard cost‑sharing and pharmacies that offer preferred cost‑sharing. Your cost‑sharing may be less at pharmacies with preferred cost‑sharing. You may go to either type of network pharmacy to receive your covered prescription drugs. The pharmacy network includes limited lower‑cost, preferred pharmacies in Suburban Arizona, Suburban Illinois, Urban Kansas, Suburban & Rural Michigan, Urban Michigan, Urban Missouri, Rural North Dakota, Suburban Utah, Suburban West Virginia, and Suburban Wyoming. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. To find a network pharmacy, or find up‑to‑date information about our network pharmacies, including whether there are any lower‑cost preferred pharmacies in your area, please call Member Services at the number on the back of your member ID card or consult the online Pharmacy Directory at Xxx.XxxxxXxxxxxxx.xxx. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. • Tier One – Generic drugs • Tier Two – Preferred brand drugs • Tier Three – Non‑preferred brand drugs • Tier Four – Specialty drugs: Includes high‑cost/unique brand and generic drugs To find out which cost‑sharing tier your drug is in, look it up in the plan’s Drug List. If your covered drug costs less than the copayment amount listed in the chart, you will pay that lower price for the drug. You pay either the full price of the drug or the copayment amount, whichever is lower. Tier 1 Generic drugs You pay $10 You pay $10 You pay $10 You pay $30 You pay $20 Tier 2 Preferred Brand drugs You pay a minimum of 25% or $10, whichever is greater, but not more than $50 for your drug You pay a minimum of 25% or $10, whichever is greater, but not more than $50 for your drug You pay a minimum of 25% or $10, whichever is greater, but not more than $50 for your drug You pay a minimum of 25% or $30, whichever is greater, but not more than $150 for yo...
Annual Deductible means the amount set forth in the Coverage Schedule which each Member must pay each Calendar Year before Benefits will be paid by the Plan.
Examples of Annual Deductible in a sentence
While the table provides you with Benefit limitations along with Copayment, Coinsurance and Annual Deductible information for each Covered Health Service, this section includes descriptions of the Benefits.
Keep in mind, you are responsible for meeting the Annual Deductible and paying any Copay or Coinsurance owed to a Network provider at the time of service, or when you receive a bill from the provider.
While the table provides you with Benefit limitations along with Coinsurance and Annual Deductible information for each Covered Health Service, this section includes descriptions of the Benefits.
The table below provides an overview of Copays that apply when you receive certain Covered Health Services, and outlines the Plan's Annual Deductible and Out-of-Pocket Maximum.
The Annual Deductible does not include any amount that exceeds the Allowed Amount.
More Definitions of Annual Deductible
Annual Deductible applies to each Calendar Year of the District’s Plan which will be July 1- June 30th. Family Maximum Deductible/Retiree Family Maximum Deductible – If eligible medical expenses equal to the Family Maximum Deductible are incurred collectively by 3 or more family members during a Calendar Year (July 1 – June 30th) and are applied toward Individual Deductibles, the Family Maximum Deductible is satisfied. A “family” includes a covered Employee and his covered dependents. Deductible Carry-Over – Eligible Expenses incurred in the last 3 months of a Calendar Year (July 1 – June 30th) and applied toward that year’s Deductible can be carried forward and applied toward the person’s Deductible for the next Calendar Year.
Annual Deductible applies to each Calendar Year of the District’s Plan which will be July 1- June 30th. Family Maximum Deductible/Retiree Family Maximum Deductible – If eligible medical expenses equal to the Family Maximum Deductible are incurred collectively by 3 or more family members during a Calendar Year (July 1 – June 30th) and are applied toward Individual Deductibles, the Family Maximum Deductible is satisfied. A “family” includes a covered Employee and his covered dependents. Deductible Carry-Over – Eligible Expenses incurred in the last 3 months of a Calendar Year (July 1 – June 30th) and applied toward that year’s Deductible can be carried forward and applied toward the person’s Deductible for the next Calendar Year. Individual Out-Of-Pocket Maximum $2,500 $5,000 Family Out-Of-Pocket Maximum $6,250 $12,500 Individual Out-Of-Pocket Maximum – Except as noted, a Covered Person will not be required to pay more than $5,000 (or $2,500 for Network services and supplies) in a Plan Year (July 1 – June 30th) toward Eligible Expenses which are not paid by the Plan. Once he has paid his out-of-pocket maximum, his Eligible Expenses will be paid at 100% for the balance of the Plan Year (July 1 – June 30th). Family Out-Of-Pocket Maximum – Except as noted, a Covered family (Employee and his Dependents) will not be required to pay more than $12,500 (or $6,250 for Network services and supplies) in a Plan Year (July 1 – June 30) toward Eligible Expenses which are not paid by the Plan. Once the family has paid their out-of-pocket maximum, his Eligible Expenses will be paid at 100% for the balance of the Plan Year (July 1 – June 30th)
Annual Deductible is defined in Section 3.2.
Annual Deductible means the total deductible amount as specified in the Schedule of Benefits, which shall be borne by the Policyholder or the Insured(s) for each Policy Year before any benefit under Section B of the Benefits Provisions becomes payable.
Annual Deductible. Amount: $0 Formulary Type: Open 2 Plus Number of Cost Share Tiers: 4 Tier Initial Coverage Limit: $4,430 True Out-of-Pocket Amount: $7,050 Retail Pharmacy Network: S2 The name of your pharmacy network is listed above. To find a network pharmacy, or find up-to- date information about our network pharmacies, please call Member Services at the number on the back of your member ID card or consult the online Pharmacy Directory at XxxxxXxxxxxxXxxxx.xxx. • Tier One – Generic drugs • Tier Two – Preferred brand drugs • Tier Three – Non-preferred brand drugs • Tier Four – Specialty drugs: Includes high-cost/unique brand and generic drugs To find out which cost-sharing tier your drug is in, look it up in the plan’s Drug List. If your covered drug costs less than the copayment amount listed in the chart, you will pay that lower price for the drug. You pay either the full price of the drug or the copayment amount, whichever is lower.
Annual Deductible. Amount: $0 Formulary Type: GRP B2 Number of Cost Share Tiers: 5 Tier Initial Coverage Limit: $4,430 True Out-of-Pocket Amount: $7,050 Retail Pharmacy Network: S2 The name of your pharmacy network is listed above. To find a network pharmacy, or find up-to- date information about our network pharmacies, please call Member Services at the number on the back of your member ID card or consult the online Pharmacy Directory at XxxxxXxxxxxxXxxxx.xxx. • Tier One – Preferred generic drugs: Includes low-cost generic drugs • Tier Two – Generic drugs: Includes generic drugs • Tier Three – Preferred brand drugs: Includes preferred brand drugs and some high-cost generic drugs • Tier Four – Non-preferred drugs: Includes non-preferred brand drugs and some higher-cost generic drugs • Tier Five – Specialty drugs: Includes high-cost/unique brand and generic drugs To find out which cost-sharing tier your drug is in, look it up in the plan’s Drug List. If your covered drug costs less than the copayment amount listed in the chart, you will pay that lower price for the drug. You pay either the full price of the drug or the copayment amount, whichever is lower.
Annual Deductible. Amount: $0 Formulary Type: Comprehensive Plus Number of Cost‑Share Tiers: 5 Tier Initial Coverage Limit: $5,030 True Out‑of‑Pocket Amount: $8,000 Maximum Out‑of‑Pocket Amount $2,000 Once your individual out‑of‑pocket expenses reach this amount, you will pay $0 for all covered prescription drugs for the remainder of the plan year including those drugs covered on the non‑Part D supplemental benefit.