Covered California Certified Enroller Practice Exam

Can health plans impose a separate prescription deductible from the medical deductible?

1. No, only one deductible is allowed

2. Yes, they can impose separate deductibles

3. Yes, but only in certain plans

4. No, it must be combined

The correct answer is: Yes, they can impose separate deductibles

Health plans can indeed impose a separate prescription deductible from the medical deductible. This practice is common among many insurance providers, allowing them to create distinct financial responsibilities for members relating to different types of healthcare services. Having separate deductibles means that individuals may have to meet one deductible amount for their medical services and a different amount specifically for their prescription drugs. This approach provides flexibility for the insurance companies to manage drug costs and healthcare services separately and can be beneficial in various scenarios depending on the structure of the plan. The design of separate deductibles can vary based on the specific health plan offered and can provide consumers with options that align better with their individual healthcare needs and financial situations. This structure can help in situations where a person may need significant medical care without necessarily needing a large number of prescriptions or vice versa. Understanding this concept is essential for navigating health insurance options and for carefully evaluating the potential costs associated with different plans.