5.1 CALENDAR YEAR DEDUCTIBLE
The deductible is the amount of Covered Expense which must be incurred during each calendar year before Medical Plan Benefits are payable. Non-Covered Expenses may not be used to satisfy the deductible. Only Covered Expenses incurred after a Participant’s effective date of coverage may be used to satisfy the calendar year deductible.
There is a separate deductible applied to each out-of-network hospital admission in addition to the calendar year deductible. Refer to the PREFERRED PROVIDER PROGRAM section of this Booklet for details.
The calendar year deductible applies to all Covered Expenses unless specifically stated otherwise. Certain Covered Expenses such as preventive health care services (e.g. routine physical examination) or outpatient prescription drugs purchased under the Prescription Drug Benefit are not subject to the calendar year deductible.
For Eligible Employees and their Dependents
The amount of the deductible for each Eligible Employee is the first $1,000 of Covered Expenses incurred in a calendar year. To meet the family annual deductible of $3,000, three or more Participants in the same family must have paid a total of $3,000 for Covered Expenses incurred in one calendar year.