A deductible is the amount you owe for covered healthcare services and most prescription medications.
How deductibles work on the LiveWELL Health Plans:
Coinsurance is the percentage you pay (with the LiveWELL Health Plans paying the majority of the costs) for covered services once you’ve met the annual deductible.
A co-pay is a flat dollar amount you typically pay for things like physician office visits and most prescription drugs.
Note: Treatment for COVID-19 is covered at 100% through Virtual Visit and eVisit for LiveWELL Health Plan members.
Covered only at Atrium Health Reproductive Medicine and Infertility is 100% after deductible with a $25,000 lifetime maximum. Benefits are available after the covered teammate has been employed by Atrium Health for one or more years.
Out-of-pocket maximum is the most money you could pay annually before the LiveWELL Health Plans pay 100% for covered healthcare services and prescription medications. This maximum amount includes deductibles, coinsurance, and copayments. This limit does not include premiums, balance-billed charges, healthcare not covered by the plan, and penalties.
The Out-of-Pocket Maximum is for the entire family, but no more than the out-of-pocket maximum for an individual. For example, with the Health Savings Plan, the family Out-of-Pocket Maximum is $10,000 but no more than $6,000 for an individual.
Please note: There is no yearly or lifetime benefit maximum for your health coverage. In addition, there is no pre-existing condition limitation.