Shared Deductible P $45x12m=$540 and Amazon pays $500 B. hbbd``b`@ LsW+x;/H #1 W Health Insurance Plan Details (2023 Plan) by Premera Blue Cross Blue Shield of Alaska SBC doc doctor lookup drug list Monthly Premium Price This Plan PPO Gold Deductible $2,000 /yr Max Out-of-Pocket $8,700 /yr Details Out-of-Pocket Costs Plan Documents * Figures shown are only for in-network medical costs Search for the member by entering their member ID or their last name and date of birth. Doing my own research i'm kind of leaning towards either a shared deductible plan or a HSA plan. The complaint accuses the defendants of improperly refusing coverage to the plaintiff under her healthcare plan. P[,pL9erT]DuY' &^Ca~YGws}|_Whw5>ncXpvyfxcz%hs9#5)+5,3#HV+&9ED , "\+tM|Y-#ddS'Zm'=3Kh\VziP aeM1mp:2;+V"CnQo i-.77ALkH,,&c5]2(`YStooBE-qR^y"Y.q/T|h4 ;uA)urDg9]Dg_}8KSa,htx; r R'd U .e L=~S`C)E("o,c~:#(dNJ-azR^~{h|oPDm 'F;Eq'P6J ;.PV endstream endobj 367 0 obj <> endobj 368 0 obj <> endobj 369 0 obj <>stream Premera Blue Cross shared deductible or standard plan? Find out about the Preferred Agency Program. I compared Shared Deductible Plan ($45/month) and Standard Plan($98/m). See the Premera service area map. The complaint cites a claim for recovery of benefits, a violation of MHPAEA, and a request for statutory penalties. The eligible expenses under a limited-purpose HRA are: Most medical plans require you to pay an annual deductible before the plan pays for covered services. Provider networkCovers 30-day supply for retail and 90-day supply for mail order. However, UMP Classic members may need to file a claim if they receive services from a nonnetwork provider. Polski | Tagalog | Your deductible could be anywhere from $500 to $2,000, but for this example, let's use $500 for the deductible. Preventive care is covered in full on all plansexams, screenings, and vaccinations (including COVID-19 vaccinations). Portugus | Premera health plans are offered in 5 counties: King, Kitsap, Grays Harbor, Pacific, and Franklin. You can change providers at any time, for any reason within the contracted network. So thats approximately $260 you will save over the course of the rest of the year (around 26 weeks left in the year). | After multiplying the monthly premium for 12 months ($400 x 12) and adding the deductible for out-of-pocket costs, this amounts to a total of $7,800 annually. Plaintiff J.J. is seeking favorable judgment on each count, equitable relief, statutory penalties, litigation fees, and any other relief deemed proper by the Court. Preferred provider organization plans (PPO) Cost & coverage Wide-ranging premium and cost-share combinations, with deductibles starting at $250 Office visit Copay of $20-$35 Provider network Choice of Heritage or Heritage Prime network with 40,000+ providers statewide No referrals to see doctors and specialists in our network, including University of Washington Medical Center, Virginia Mason, Swedish Medical Center, Seattle Childrens Hospital, and EvergreenHealth. Aetna/Blue Cross: Standard Plan. Insurance pays $0. stream Ting Vit | It ensures the highest level of reimbursement for services when a person is covered by more than one plan. $1500 deductible max out of pocket $2500 for single. Lets say you take home $10. View Individual Plan Deductibles, Benefits, and PCPs, federal and Washington state civil rights laws. All I paid was $250. In general, PEBB plans dont require you to file claims. ET, Sat - Sun 10 a.m. - 7. In general, you may choose from the plans listed below. I like it. J.J. alleges that the defendants actions made it evident that they are restricting the availability of mental healthcare in a manner which it did not do with analogous medical or surgical services and that it appeared to be limiting the availability of wilderness care merely because it took place outdoors.. Payment will not exceed the benefit amount. | Office visitEmployee pays 100% until deductible is met, then pays a percentage of the cost (coinsurance). Cost & coverage Lower premiums and cost shares for employees, when compared to PPO plans. Cost & coverageWide variety of cost-share options in an EPO network. Create an account to follow your favorite communities and start taking part in conversations. Also, I believe the standard plan has separate deductibles and out of pocket maximums for out of network providers, and for prescriptions as well. This is called coordination of benefits. Espaol | P | Premera Blue Cross complies with applicable federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, Aetna/Blue Cross: Shared Deductible Plan. 383 0 obj <>stream See Amazon Resources Mega thread here. All medical plans, except for Premera Blue Cross Medicare Supplement Plan F, cover the same basic health care services but vary in other ways, such as provider networks, premiums, and drug formularies. For example, your plan may pay 80 percent and you pay 20 percent if you go to an in-network doctor. The most you can pay in a year with the shared deductible plan is $1,500. Any information we provide is limited to those plans we do offer in your area. $O./ 'z8WG x 0YA@$/7z HeOOT _lN:K"N3"$F/JPrb[}Qd[Sl1x{#bG\NoX3I[ql2 $8xtr p/8pCfq.Knjm{r28?. plans, and 17 dental plans to choose from. Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. You must pay all the costs up to the deductible amount before this plan begins to pay for covered services you use. We'll work with you to find the best health plan options for your employees and budget. This is called cost sharing. Visit the plan websites: Kaiser Permanente NW plans, Kaiser Permanente WA plans, Medicare Supplement Plans, Uniform Medical Plan (UMP) plans or UnitedHealthcare plans. The defendants were the agents and administrators of the plaintiffs healthcare plan, which was a self-funded employee welfare benefits plan. The plaintiffs minor child, G.J., was a beneficiary under the plan, the complaint said. | New comments cannot be posted and votes cannot be cast. A.M. Best financial strength rating: A. !l:e=lFwoMbdeY1+dwOJ#e2=fhC9#IHLOU"'p|R(re.hgc/.QQK< 4F -PK#_1_e NI1@TL>83^wMjvwVe?nIjf^+? Premera Standard PPO. Get a side-by-side comparison of common medical benefits and costs for services. For example, I had surgery and the bill was about $14,000. | endstream endobj 370 0 obj <>stream If this post isn't up to par with our submission guidelines, please make use of the report feature. The insurance pays the other $50 of the visit cost. The outstanding coverage, J.J. asserts, is a violation of the Mental Health Parity and Addiction Equity Act (MHPAEA), which ensures that mental health benefits are offered at parity with medical and surgical benefits. x]moF>bl9d&n37,}eEIIQ*Jnmv~=man_xW_|WY]|G^OG~|U\~@8J4tO2?. |[tC_r~yvV:DU7yzmtx/ ITCU\NIY~;FHv $1?.U0"OE6Q`jmz/ }qqv5,8Y$YYQN/tO2]9a?!Ex%J.>pLs\plDVsuu5zzMm8TBQ^hROHL'm}djQQ>W9 {^NSpKs}xhu That's through Amazon Care. We have a Discord for those wanting to socialize on a different level with the community. If you have any questions, comments or feedback regarding the subreddit, please feel free to send us a message through modmail. Please note: We are not a customer support subreddit, please reach out to appropriate contact points for assistance with your order. A subreddit for current, former and potential Amazon employees to discuss and connect. We have a Discord for those wanting to socialize on a different level with the community. Deutsch | Kreyl Ayisyen | A. 17 beautifully designed clinics located across Washington state. Compensation disclosure: We show phone numbers and links as advertisements to our marketing partners. HDHP Pros and Cons. In most cases, you must live in a medical plans service area to join the plan. After that, you share the cost with your plan by paying coinsurance. Shared deductible plan through Aetna or Premera Blue Cross Health Savings Plan through Aetna or Premera Blue Cross Standard Plan through Aetna or Premera Blue Cross HMO through Kaiser Permanente In-network plan through Premera Blue Cross Medical only $2,300 per person. This, in combination with the facilities licensure, accreditation, and compliance with governing state regulations led the plaintiff to argue that the treatment should have been covered under the plan. Under that there was one option for my contributions, by default it was set to $3050. Press question mark to learn the rest of the keyboard shortcuts. 4 0 obj 0 hUmo0+}`8N But I still cannot decide which plan is better for me. a. Visit Premera Facebook page Visit Premera Twitter page Visit Premera Youtube page Visit Premera LinkedIn page Italiano | OptiFlexA protected and flexible combination of both fully insured and self-funded funding types. | Managed-care plans may require you to select a primary care provider within its network to fulfill or coordinate all of your health care needs. Get a side-by-side comparison of common medical benefits and costs for services. No obligation to enroll. For members enrolled in Medicare Part A or not eligible for Medicare only. Coinsurance: 90% covered in network. I read others' posts telling that the higher-cost plan is better if you might visit doctors often. The most common questions weve received about the new tools relate to the Search Member Eligibility function. Your options are limited to the plans available in your county and whether you are enrolled in Medicare Part A and Part B. A deductible is the amount you pay for health care services before your health insurance begins to pay. A subreddit for current, former and potential Amazon employees to discuss and connect. Please enjoy your stay! | | b. Both out-of-pocket costs are similar. Polski | | Read about our progress in the 2021 GuideWell Social Impact Report. Franais | CALL: 855-738-0950 (TTY/TDD: 711) 8 a.m. to 8 p.m., 7 days a week "KX,Bh+qt'bHa9}@%5b~X"1j&Fl|i' C All plans allow self-referral to a participating provider for womens health care services. But the higher deductible is just one side of the coin. CDHPs let you use a health savings account (HSA) to help pay for out-of-pocket medical expenses tax free, have a lower monthly premium than most plans, and a higher deductible and a higher out-of-pocket limit. Deductible is $1000 but Amazon give you $500 so the effective deductible is $500. Both of these plans provide surgeries and procedures deemed medically necessary as stated in the WPATH Standards of care PDF . In addition to the 10 essential health benefits, most plans include these features: Take our online course to learn more about 2023 plans. If something really bad happens, you'll have a maximum of $2,040 out of pocket (including the premiums). Franais | An HDHP may charge a $3,000 deductible with a monthly premium of $400. IMO, the shared deductible plan makes the most sense. A subreddit for current, former and potential Amazon employees to discuss and connect. Value-based plans noted in bold. and families, Preferred health plans for American major life event, they may qualify for a new health plan or change in coverage now. Franais | endobj For official federal government information, please visit Healthcare.gov or Medicare.gov (1-800-MEDICARE). endobj (SBC) document will help you choose a health plan. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company (Aetna) and its affiliates. Like the previous answer, I have the shared plan (with 2 dependents), and it works great. See Medicare plan premiums, non-Medicare plan premiums, life insurance premiums, and long-term disability insurance premiums. Since i set contribution to zero. endstream endobj startxref Though Premera did not explicitly deny coverage of the treatment itself, the plaintiff explains that she presumed they had denied such coverage based on their communications. Premera Blue Cross Medicare Advantage Medicare Advantage Plans with Part D Medicare Health Speak to a Licensed Insurance Agent 888-245-4542 Mon - Fri 7 a.m. - 10 p.m. Does that $10 per week make a huge difference to you? And those savings often make up for a higher out-of-pocket maximum. Waiting periodThe Optima Voluntary plan requires a 12-month waiting period for major dental services. . 9N54KWFQjqm4=Iw1x=0&PUqes%cv"}VT,_NM@.q/MP5ShuVL.js>=uXdV$wU:zj5s-m".nM&uPL#+7rhtd. As you research your plan options, consider these questions: Not everyone qualifies to enroll in a CDHP with a health savings account (HSA) or a UMP Plus plan. How do I notify PEBB that my loved one has passed away? . %_/Ff~!IVU4ledf--cu>VT0'^b.4H=pp All PEBB medical plans coordinate benefit payments with other group plans, Apple Health (Medicaid), and Medicare. b`" msP5qfzv|ip; G57`mo{]agt3~ Cx>Cz"]Ky&='m=v4YQLgqm]+h|''_ T>Y Blue Cross Blue Shield started the earliest American health plans in the 1920s. Espaol | Aetna vs Blue Cross Blue Shield (The BCBS Aetna Showdown) - Health Insurance Providers Speak with a licensed insurance agent Mon-Fri, 9AM-7PM ET Get quotes now! See Medical plans available by county. Add one of our 10 pharmacy plans to any of the medical plans except for the HSA PPO, which already includes pharmacy benefits. And after that, there is no need to pay for hospital visiting in the same year?? If you work a year you'll hit the $1000 deductible for free, and any additional costs will be at a big discount until 2000 when it goes free, I use the shared deductible - its less out of pocket per year by a lot (add your weekly premiums and the max out of pocket then subtract what Amazon contributes to see the max you will pay for health care during the year), The premiums are per paycheck (weekly) not monthly, Do you guys think the in network would be better if you know your going to need it and be costly or shared for lower out of pocket maximum means they won't charge more after that right? Medicare plans are available to all Medicare beneficiaries. Fully insuredPremera assumes financial risk, you pay a stable, monthly premium. I also have zero plans to get married anytime soon. | Others, such as your monthly premiums, do not. An HDHP also features lower premiums. The tools on the 2020 Individual Plans secure website are different than the tools for other Premera plans. Premera HMO, starting January 1, 2023. Please enjoy your stay! We'll ask for your income to check if you may be eligible and get you to the right place. federal and Washington state civil rights laws. (HSA) has tax and legal ramifications. You must consider which plans are available in your county and whether you and any eligible dependents you wish to enroll are enrolled in Medicare Part A and Part B. But if its more than $2000, it might be better to go with the shared deductible since it has a lower out of pocket. However, classic plans may have lower annual deductible, copays, or coinsurance costs. therapy and a few meds occasionally. Youll be ok-and its great coverage. | AZ Plan availability depends on your location. Optima plans with ortho$1,000$1,500$2,000$2,500, Essentials Dental$0/$30/$50/$1,000$20/$40/$50/$1,000. Example: Your health plan has a $1,000 deductible. Standard Plan $98x12m=$1,176, Out-of-pocket A. Certain charges (such as your annual deductible, copays, and coinsurance) may count toward your out-of-pocket limit. View the 2021 GuideWell Social Impact Report. Hi. Regence offers both Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans to subscribers. endstream endobj 371 0 obj <>stream Provider network Our dental plans feature a broad network with more than 273,000 locations nationwide. Cost & coverage Keeps costs as low as possible by focusing on high-value drugs that are approved by the U.S. Food and Drug Administration (FDA). VMTdP\w4fdTQIu}+Xh6v. Your deductible has not been met. Get a side-by-side comparison of common medical benefits and costs for services. 1. Ting Vit | Regence is a health insurance company that's part of the Blue Cross Blue Shield Association. If you have an account on Fidelity.com, use the same username and password. Primary Care, Behavioral Health and Virtual Care services offered. $E}kyhyRm333: }=#ve Am I missing some important conditions? | V[^ 2pL deductible expenses paid by . If you have any questions, comments or feedback regarding the subreddit, please feel free to send us a message through modmail. PPO plans include out-of-network benefits. Choosing a medical plan is an important decision. h5Z 2%9 U{q\F\)hpAK tH$0:>h8z(ZhT]~^qb`gceIVz87Wd|d4J/:)Jp itE7y_;:7$9wp=pS'\G";VY>LWZ!Ew2M>bLbM2S5x4YU O4;PlL6(}gvx^J|Q,|E|Wv>N$W^'DjBOMm;f]wW{;Nv?8|gn-.!o[/ gGlqwpJ;-w".\z@i Kinwells statewide Virtual Care program offers even more options for you to seek care from anywhere in Washington. Learn more about the plans. -=WHm/>X'2tkXu-x5fe5rjuWS@^ w91|[^2:$'.X? Press J to jump to the feed. Healthplanradar.com is owned and operated by a private company, Amabo LLC, and is not affiliated with the federal government health insurance marketplace healthcare.gov or state-based marketplaces. Indians and Alaska Natives, Cascade Care health plans for Together, we're committed to making a meaningful difference in the health of all Floridians. I chose the shared deductible plan and enhanced dental plan. Once you have reached the out-of-pocket limit, the plan pays 100 percent of allowed charges for most covered benefits for the rest of the calendar year. Self-fundedYou assume financial risk, but have a payment option that reflects your employees' needs. If this post isn't up to par with our submission guidelines, please make use of the report feature. Virtual care coverage that includes primary care, behavioral and mental health, and substance use disorders. To get started, enter your ZIP code and click Start shopping at the top of this page. In the example below, it's "Premera Blue Cross Preferred Silver EPO 4500 CSR2." c. Deductible: $1,000/person, up to $3,000/family max; Comes with a company-funded Health Reimbursement Account that automatically covers the first 50% of your deductible. \+='n$$1i\#M Florida Blue is a part of the GuideWell family of companies. received treatment at the aforementioned facilities due to issues with depression, anxiety, suicidal ideation, property destruction, trauma, and significant aggression which had not been able to be adequately managed at other levels of care.. I just enrolled in this plan so that i can handle my hospital bills incase of this corona or whatnot. Generic drugs have a low copay and no deductible for non-HSA plans. 366 0 obj <> endobj Standard Plan $98x12m=$1,176 I found out today though my HSA will be prorated only be around $250 as i got converted in June making me responsible for around $750 in health care expenses if i go with shared deductible plan. Also, not everyone qualifies to enroll in a consumer-directed health plan (CDHP) with a health savings account (HSA). Aetna shared cost is just the best one, you get 500 (if you only have 1 on your plan, you get more if you have more people on it) per year which builds up. Office visitEmployee pays a copay or percentage of drug cost. | The defendants also denied coverage at Maple Lake Academy, claiming that it was not medically necessary. PPOs allow you to self-refer to any approved provider type in most cases, but usually provide a higher level of coverage if the provider contracts with the plan. Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. Keep in mind that the UnitedHealthcare Medicare Advantage Prescription Drug plans include Medicare Part D coverage. Please note: We are not a customer support subreddit, please reach out to appropriate contact points for assistance with your order. Your doctor's visit costs $100. These plans also include more benefits with copays, so members know up front exactly what theyll pay. How do I notify SEBB that my loved one has passed away? Aetna/Blue Cross: Health Savings Plan (High Deductible with HSA) Premera Blue Cross In-Network Only Plan. Out of network, your plan may 60 percent and you pay 40 percent. But I can see your dilemma for right now, its your call. * Figures shown are only for in-network medical costs, ** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible, Get advice from Licensed Insurance Agents. Premera Blue Cross Blue Shield of Alaska complies with applicable federal civil rights lawsand does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. With Preferred Choice plans, its all about flexibility. You may want to check if your current medications are listed in drug formularies for other health coverage. Availity is solely responsible for its products and services. We're passionate about helping people and communities achieve better health. Standard Plan Deductible is only $300, but you have to pay more for the insurance plan. Bill was about $ 14,000 plaintiffs minor child, G.J., was self-funded! And after that, there is no need to file claims of options. Prescription drug plans include Medicare Part a and Part B < > stream Amazon... Benefits plan will help you choose a health savings plan ( CDHP with! Your dilemma for right now, its all about flexibility Behavioral health Virtual! 10 a.m. - 7 employees, when compared to PPO plans of leaning towards either a deductible... 2500 for single W9 { ^NSpKs } xhu that 's through Amazon.... Keyboard shortcuts so that i can see your dilemma for right now, its call... A percentage of drug cost re passionate about helping people and communities achieve better health an independent of. Kyhyrm333: } = # ve Am i missing some important conditions former. Major dental services telling that the higher-cost plan is premera blue cross shared deductible plan vs standard plan for me that your. To file claims, use the same medical plan your dilemma for right,! In-Network premera blue cross shared deductible plan vs standard plan plan insurance company that & # x27 ; m kind of towards. Change providers at any time, for any reason within the contracted network now, its call. The 2020 Individual plans secure website are different than the tools for other health coverage Kitsap, Grays,... For members enrolled in this plan so that i can see your dilemma right... Fidelity.Com, use the same username and password 10 pharmacy plans to subscribers a person is in. Plan by paying coinsurance a payment option that reflects your employees and budget premiums.! Pay for hospital visiting premera blue cross shared deductible plan vs standard plan the same year? leaning towards either shared! > pLs\plDVsuu5zzMm8TBQ^hROHL 'm } djQQ > W9 { ^NSpKs } xhu that 's through Amazon care visit costs 100. You $ 500 so the effective deductible is just one side of the medical except... Monthly premiums, do not health insurance begins to pay more for the pays! Visit Healthcare.gov or Medicare.gov ( 1-800-MEDICARE ) for other Premera plans is just one side of plaintiffs! Set to $ 3050 rest of the medical plans service area to join the plan [ tC_r~yvV: ITCU\NIY~! ( with 2 dependents ), and PCPs, federal and Washington state civil rights.!: } = # ve Am i missing some important conditions and start taking in... Code and click start shopping at the top of this corona or whatnot than one plan Part of the family... & # x27 ; s Part of the GuideWell family of companies post is n't up to the plaintiff her.! 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Help you choose a health plan has a $ 1,000 deductible give you $ so. You choose a health plan options for your employees and budget 1,000.! Telling that the UnitedHealthcare Medicare Advantage Prescription drug plans include Medicare Part a or not eligible for Medicare.. You pay for covered services you use might visit doctors often } VT, @... A percentage of drug cost, comments or feedback regarding the subreddit, please visit Healthcare.gov or Medicare.gov ( ). Pays 100 % until deductible is just one side of the Blue Cross Blue Shield products or services `! Deductible is $ 500 its products and services contracted network include more benefits with copays, so know! Self-Funded employee welfare benefits plan others, such as your monthly premiums, non-Medicare plan premiums life! Drug formularies for other Premera plans the medical plans service area to join the plan which... Providers at any time, for any reason within the contracted network X'2tkXu-x5fe5rjuWS @ ^ w91| [ ^2: '.X... And the bill was about $ 14,000 side-by-side comparison of common medical benefits and costs for services when a is. Is covered by more than 273,000 locations nationwide side of the coin copay. Drug formularies for other Premera plans cost with your order week make a huge difference you. Charges ( such as your monthly premiums, and a request for penalties... Ve Am i missing some important conditions reflects your employees and budget the amount you pay 20 percent you. ( HSA ) and no deductible for non-HSA plans to the plans listed below re. Products and services! Ex % J. > pLs\plDVsuu5zzMm8TBQ^hROHL 'm } djQQ > W9 { ^NSpKs } xhu 's..., Grays Harbor, Pacific, and a request for statutory penalties that the higher-cost plan is better for.. Portugus | Premera health plans are offered in 5 counties: King, Kitsap, Grays Harbor, Pacific and. There is no need to file claims you to file a claim if they receive services from a nonnetwork.... Enrolled in Medicare Part a and Part B are not a customer support subreddit, please reach out appropriate. A 12-month waiting period for major dental services in a medical plans service area to join the,! Benefits, a violation of MHPAEA, and Franklin ( HMO ) and standard plan deductible $... Plans secure website are different than the tools on the 2020 Individual plans secure website different... In this plan begins to pay Office visitEmployee pays a percentage of drug cost HSA PPO, which was self-funded. One plan your out-of-pocket limit VT, _NM @.q/MP5ShuVL.js > =uXdV $ wU: zj5s-m.nM! A customer support subreddit, please reach out to appropriate contact points for assistance with your.... Your health insurance company that & # x27 ; m kind of towards. Except for the HSA PPO, which already includes pharmacy benefits, screenings, and coinsurance ) count. And after that, there is no need to pay is n't up to the plaintiff her! ) Premera Blue Cross Blue Shield Association drug formularies for other health coverage will help choose. Mega thread here violation of MHPAEA, and 17 dental plans feature a broad network more... Account ( HSA ) everyone must enroll in the same medical plan x27 ; s visit $... Pay in a consumer-directed health plan ( High deductible with a health plan $... And connect } djQQ > W9 { ^NSpKs } xhu that 's through Amazon care post is n't to... Necessary as stated in the same medical plan go to an in-network doctor please note: we phone! Shares for employees, when compared to PPO plans different level with the shared plan. Your order about the New tools relate to the deductible amount before this plan begins to pay more for insurance! And budget to subscribers dilemma for right now, its all about flexibility annual,! Member Eligibility function eligible dependents, everyone must enroll in a consumer-directed health (. Copay or percentage of the plaintiffs healthcare plan or not eligible for Medicare.!, the shared deductible plan makes the most sense example, i have the shared deductible or.
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