A family health insurance deductible is a predetermined fixed amount that the policyholder or a family should pay during claim settlement for the coinsurance to start covering every family member. Every member of the household has a separate deductible, and the family also has a deductible. The family deductible is the sum of all individual deductibles.
The insurer will not pay for the other family members' covered services until the family deductible or the individual deductible is satisfied. When the total cost of all family members' covered services equals the family deductible level, the family deductible is satisfied.
What is not included in the family deductible?
Several expenses are not covered under your health insurance, so they will not count toward your deductible even though you pay for them from your pocket. After understanding how does family deductible work, it's essential to understand services that are not included in the family deductible.
1) Cosmetic surgeries
Any cosmetic surgery undertaken that does not promote proper bodily function or is not medically necessary to prevent or treat illness or diseases is not covered by insurance.
2) Copays
The money paid for copays is generally not counted towards the deductible. However, it is counted toward your out-of-pocket maximum for the year.
3) Household help
Even if medically recommended, household help is not covered by health insurance. However, a few expenses paid to an in-home nurse or caretaker may count toward the deductible.
4) Health and sports club fees
Any payment made for using health and sports clubs is not covered by insurance unless it is medically recommended.
5) Natural medicines
Health supplements, such as nutritional or herbal supplements, vitamins, and minerals tablets, are not covered by insurance unless they are medically recommended in writing for the treatment of a specific medical condition.
6) Out-of-network-providers
If a policyholder uses an out-of-network medical provider in a non-emergency situation, the cost is generally not counted towards the health insurance plan’s regular deductible.
However, if your plan covers out-of-network care, it will have a separate deductible for out-of-network services, which are generally higher than the plan’s regular in-network deductible.
7) Non-prescription medicines
Medication not prescribed in writing by healthcare providers is not covered by insurance.
Conclusion
The extent of health insurance coverage and its deductible vary by plan. You should consult your insurance provider about what is covered and what is not under your family deductible. A family health insurance deductible will undoubtedly help keep the overall cost more manageable, especially if you have a large family.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the Insurance industry and products. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.