Three months into a new benefits year, do you know how much of your deductible you have paid? How about your out-of-pocket maximum?
You can keep track through the Blue Cross Blue Shield of Michigan/Blue Care Network Member Portal where you can see exactly what’s been billed, how much was approved, and how much was paid or applied toward your deductible.
Among the benefits that reset each year on January 1 are your medical deductibles and out-of-pocket maximums. If you’ve never acquainted yourself with these terms, here’s a quick guide:
- Deductible: The amount you must pay for non-routine services before insurance pays any amount, typically 70 to 80%.
- Coinsurance: The remaining amount you must pay for a service—if you have already reached the deductible—typically around 20-30% of the amount.
- Copayments: Payments you are responsible for that are connected to certain services, such as office visits.
- Out-of-pocket maximum: The limit of what you pay—which includes copayments and coinsurance—in a calendar year before 100% of covered services are paid for the rest of the year.
It’s also important to note that when it comes to preventative services, all MCC medical plans cover them at 100%, with no calendar year deductible required.
Regarding your prescriptions
If you haven’t already, now is a good time to check the list of prescription drugs covered by your current medical plan to see whether there have been any changes to the classification of the medications you take since the new year began.
If you find you are paying a different amount for the same medicine, it may be because it has been reclassified. If this happens, you may wish to discuss it with your prescribing physician.
If you are receiving your prescription medications by mail order, some auto-renew prescriptions may need to be resubmitted to the mail order pharmacy for you to continue to receive a smooth auto-ship via the U.S. Postal Service.
For questions about any of these items, reach out to the MCC Benefits team at the contact information at the bottom of this email, or contact BCBSM/BCN at the number listed on the back of your insurance card.
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