A deductible is the amount a member must pay out of pocket for covered medical services before their insurance starts to share the cost. For example, if a plan has a $500 deductible, the member pays 100% of eligible services until they reach that $500 limit.
Annual deductibles reset on January 1 of each year.
Once the deductible is met, coinsurance begins. Coinsurance is the percentage of the cost that the member shares with the insurance plan. For example, since all THT medical plans have 20% coinsurance, THT pays 80% of the allowed amount and the member pays 20% for covered services.
Putting it together: before the deductible is met, the member pays the full allowed cost of services; after meeting the deductible, the cost is split between the member and the insurance based on the coinsurance percentage.
How to see your progress towards your medical deductible
Sign into UMR.com
Via your computer:
Go to UMR.com and click Log in/Register
Select Member and log in using your HealthSafe ID
Hover your cursor over Coverage and benefits and select Benefits
In the "Network level" dropdown, change the selection to "Tier two"
Select Apply
Scroll down to the Benefits Usage section to view progress towards your deductible and out-of-pocket maximum.
Via your smartphone:
Download the UMR | Health app.
Sign in with your HealthSafe ID.
Under the Benefit Usage tile, tap View benefits
Under the Coverage type dropdown, change the selection to Medical - Tier Two
Tap Select
Tap Benefits usage to expand the section and view progress towards your deductible and out-of-pocket maximum.
Call UMR Member Services
If you don't have internet access or prefer to speak to someone, call 855-858-6860 for assistance in viewing progress towards your deductible and out-of-pocket maximum.