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The Basics: What Do You Pay For and When?
You and Alcoa share in the cost of your benefits. Alcoa pays the majority of the costs, which adds up to more than $7,000 per retiree/year. Your portion of the costs are paid in three ways.
Monthly Premium Contribution
Each month, you share the cost of your plan either through a deduction from your pension or direct billing. This amount was on your enrollment worksheet when you enrolled for your benefits.
Annual Deductible
When you use medical care during the year, you pay for all of your medical services until you reach your annual deductible. After you've reached this amount, Alcoa begins to share the cost of your medical care through coinsurance.
However, not all services require you to meet a deductible. Take a look at your medical chart to see which ones require you to meet a deductible.
Coinsurance
After you've spent enough on medical services to reach your annual deductible, you and Alcoa share the cost of your medical expenses through coinsurance, which is a percentage of the cost. Alcoa pays the majority of the cost. Click on the medical plan you're enrolled in to see your coinsurance percentage:
Annual Out-of-Pocket Maximum
Some people think of their annual out-of-pocket maximum as the "worst-case scenario"- basically, the most you'll ever pay for medical care in one year. Keep in mind, most employees never come close to reaching this maximum.
After you have enough out-of-pocket expenses to reach your annual out-of-pocket maximum, Alcoa pays 100% of your eligible medical costs for the remainder of the year. Your out-of-pocket maximum includes the money you've spent toward reaching your annual deductible plus your share of coinsurance costs. Each plan has different out-of-pocket maximums, and the maximums are tracked on an individual basis and a family basis.
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