Consumer Driven health plans are becoming increasingly popular, but they are confusing. Your annual medical fund is the amount of covered benefits you will receive from first dollar at 100% coverage. In other words, for approved medical epenses from in-network providers, you will pay nothing for the first $2,500 of medical epenses each year. Once you have ehausted this fund, you will be responsible for 100% of the medical epenses, up to your selected deductible amount. Once you have met the deductible, the coinsurance amount of the policy takes effect. For eample, let’s say your plan has a $2,000 deductible with a 30% coinsurance. If your incur $10,000 of medical epenses in the year, your out-of-pocket will be broken down into three classes: 1) First $2,500 – You Pay Nothing 2) $2,500 - $4,500 – You Pay 100%, or $2,000 3) $4,500 - $10,000 – You Pay 30%, or $1,650 Your total out-of-pocket for the $10,000 in medical epenses would be $3,650. This type of health plan is most effective for those families with low medical epenses that aren’t likely to eceed the annual medical fund. Hope that helps.. - Tuesday, December 1, 2009 @ 11:55 am