Deductible Carry Over
Deductible Carry Over
Blue Cross Evidence of Coverage - Employer Group Gold PPO
Blue Cross Evidence of Coverage – Employer Group Gold PPO
Health Net Glossary
Health Net Glossary
definitions - glossary
definitions – glossary – Specimen EOC Evidence of Coverage

Many plans offer a provision called a deductible carryover. This provision allows you to carry over to the next year any unmet portion of the deductible that you, or your family, run up in October, November and December. For example, assume you had no medical claims in the first part of the year. In November, you run up $350 worth of claims. If your deductible was $500, you would start the next year with $350 of your $500 deductible already meet.  Example

Last quarter deductible carry over has gone by way of the dinosaurs – carriers no longer offer this.

However, there is deductible credit for PPO plans  since all plans are set up for Calendar Year and a renewal won’t effect this nor  a carrier change in the middle of the year since deductible credit for the yearly medical deductible is given by the new carrier (client has to submit EOBs)  9.11.2015 email from Heide

Definition – Investopedia

LISA Broker Wholesaler – How and what you need to do to get credit when moving from one insurance company to the other.

 

Benefit Period

The length of time we will cover benefits for Covered Services. For Calendar Year plans, the Benefit Period starts on January 1st and ends on December 31st. For Plan Year plans, the Benefit Period starts on your Group’s effective or renewal date and lasts for 12 months. (See your Group for details.) The “Schedule of Benefits” shows if your Plan’s Benefit Period is a Calendar Year or a Plan Year. If your coverage ends before the end of the year, then your Benefit Period also ends.  EOC Page 151

 

Crediting Prior Plan Coverage

If you were covered by the Group’s prior carrier / plan immediately before the Group signs up with us, with no break in coverage, then you will get credit for any accrued Deductible, if applicable and approved by us, under that other plan. This does not apply to people who were not covered by the prior carrier or plan on the day before the Group’s coverage with us began, or to people who join the Group later.

If your Group moves from one of our plans to another (for example, changes its coverage from HMO to PPO), and you were covered by the other product immediately before enrolling in this product with no break in coverage, then you may get credit for any accrued Deductible, if applicable and approved by us.

If your Group offers more than one of our products, and you change from one product to another with no break in coverage, you will get credit for any accrued Deductible, if applicable.

This Section Does Not Apply To You If:

· Your Group moves to this Plan at the beginning of a Benefit Period;
· You change from one of our individual policies to a group plan;
· You change employers; or
· You are a new Member of the Group who joins the Group after the Group’s initial enrollment with
us.

 

Covered CA Definitions
Players & Terms
Health Net Definitions
Co-Insurance?
Health Net – Know your coverage costs
 
Deductible

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