The most you’ll pay for care during a benefit period – most often a calendar year – before HAP starts to pay 100 percent of your care.
All copays, coinsurance and deductibles count toward your out-of-pocket limit.
Deductibles by plan type
All HAP plans have individual deductibles and family deductibles, but family deductibles can work differently based on the type of plan you have.
For family coverage, there are two different deductibles: one for each family member and one for the family as a whole.
- Deductible for each family member: When a family member meets their individual deductible limit, HAP will start paying the whole amount for covered care for that family member.
- Family deductible: When the family collectively meets the family deductible, health care for the whole family is covered – even if some family members haven’t met their individual deductibles.
There are no individual deductibles. All family members work together to meet the family deductible.
The deductible can be met by a single family member or a combination of family members. Once it’s met, health care for the whole family is covered.
Aggregate with a cap
This works like the aggregate deductible, except each family member has a limit on what they can add to the family deductible.