FAQ MEDICAL BENEFITS

  • Frequently Asked Questions - Medical Benefits

     

    What is a deductible?
    A deductible is the amount of money you pay before your health plan will pay its share. For example, if you have a health plan with a $250 deductible, you must reach that amount before your health plan begins paying.  Your deductible can be found on your medical plan Benefit Summary.

    Do I have to meet my medical plan deductible annually?
    Yes. Medical plan deductibles are reset to “$0.00” at the start of every plan year (January 1st). 

    How can I tell if I’ve met my medical plan deductible?
    Your Explanation of Benefits (EOB) will state how much you have paid toward your deductible.

    What is a copay?
    A copay or copayment is a small fee you pay for each doctor's office visit, medical service or prescription. For example, if you have a health plan with a $50 copayment for a specialist doctor's office visits. This means every time you visited your doctor, you would pay just $50. Your medical plan copay information can be found on your plan Benefit Summary.

    What is a specialist?
    A specialist is a doctor who treats certain illnesses or injuries. For example, a surgeon is a specialist. A doctor who treats allergies or heart problems is also a specialist.

    Can I add a family member to my medical plan?
    You can add a family member during our annual open enrollment period in May or when you experience a life event such as marriage, divorce, birth or adoption of a child, loss of coverage, loss of COBRA, etc. You have 30 days from the date of the life event to elect benefit changes otherwise you wold have to wait for the next open enrollment period. 

    When is Open Enrollment?
    WCBOE employees participate in our annual open enrollment in May of each year. Benefit election changes made during open enrollment are effective September 1st. You will receive notification from Human Resources with more information regarding open enrollment.