What's an Annual Deductible?

The annual deductible is a fixed dollar amount you pay for covered services each calendar year or plan year before HMSA will pay for certain services. To determine if your deductible maximum is based on calendar or plan year, please review your Guide to Benefits. Please consult the “Benefit and Payment Chart” in your Guide to Benefits to find out if the annual deductible applies to a specific service.

To view your plan’s annual deductible amount and how much you’ve accumulated toward your annual deductible, please log in to My Account on hmsa.com and click the View Benefits link on the right of the home page. You can also call HMSA Customer Relations for assistance.

Amounts that don’t apply

Generally, the following amounts don’t apply toward the annual deductible:

  • Copayments and payments for services not subject to the annual deductible.
  • Payments for services subject to a maximum once you reach the maximum.
  • The difference between the actual charge and the eligible charge for services you receive from a nonparticipating provider. In some cases, this amount can be significant.
  • Payments for noncovered services.
  • Any amounts you owe in addition to your copayment for covered services.

For additional important information, we encourage you to read: