We each have a deductible, which I think is $5000/person. We must foot the bill for the first $5K. IOW, each time we go to the doctor, hospital, walk in clinic, to any kind of therapy, we pay till we have reached $5000 for the patient. Each of us, dh and me, has this deductible.
Once the deductible is met Blue Cross pays 70% and we pay 30% till we reach our out of pocket limit, which escapes me right now but I think it’s $2000. This is for each one of us, not combined.
After we reach the out of pocket limit, BC pays 100%.
Medication has its own deductible as of 2-3 years ago. So any prescription purchases goes against the prescription deduction, not the $5000. I think the prescription deductible is $1000.
Each state is different on insurance legalities and policies. Each policy, even within the same company, can be different. Your mileage may vary.
Rarely do we meet the $5000 deductible unless one of us ends up in the hospital due to illness or a procedure. We are fortunate we qualify for a Health Savings account (HSA) due to the high deductible. We fully fund it each year. We do not use it for normal doctor’s visits or normal prescription purchases. We save it for big bills that are more than a couple of $100. It is helpful to have one at tax time because whatever is put into it comes off the top at tax time. Also if you still have some left at the end of the year it can roll over. You are not penalized for leaving some in the account at year’s end.