Help understanding how this works?

I recently got a new job and they offer health insurance. I signed up for it and it’s Premera Blue Cross. Honestly this is my first time getting insurance thru my job so I’m new to all of this. I have to go get my chicken pox vaccine so I looked online to see if my insurance covers it and this is what it said? “Deductible does not apply to this benefit” What does deductible does not apply to this benefit mean? And then it says “$5,000 left till out of pocket maximum is met” what is an out of pocket maximum? And I’m still unsure of if my health plan will cover my vaccine or not? Any help!? I feel so stupid trying to understand all of this but I’m honestly fairly young and was scared to ask HR what any of this meant :woman_facepalming:t2: edit: I am 25, live in Idaho but work in Washington and make roughly $38,000 a year.

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You have a deductible, which is the amount you must pay before your insurance starts covering costs. In this case, the deductible doesn’t apply, so you don’t have to pay for the vaccine.

After you meet your deductible, you and your insurance share the cost of medical bills. Once your payments reach $5,000, you don’t have to pay anything for the rest of the year.

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Thank you!:blush: that does make sense. My other question for you would be, since I have not met my deductible does that mean I still would not have to pay for the vaccine?

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Correct it doesn’t apply, so that means your vaccine is covered despite the deductible not being met

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You should ask HR or your plan broker how your plan works.

If your plan says “Deductible does not apply to this benefit,” you might only pay a copay or coinsurance for that service.

The out-of-pocket maximum is the most you will pay for in-network covered services in a year.

Most health insurance plans cover the chickenpox vaccine. However, check with your insurance provider before getting vaccinated to confirm coverage and find out if you have any cost-sharing requirements, like deductibles or copays.

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Under the Affordable Care Act (also known as ObamaCare), routine immunizations are fully covered. If your insurer has an arrangement with a drug store, you can get your vaccinations there. If not, you can go to another drug store or your doctor’s office. Either way, the vaccinations are covered 100%.

This article provides an overview of $0 cost preventive care: What’s Preventive Care and Is it Covered by Insurance? | eHealth.

If you get a Covid-19 or Flu shot, these are also covered at $0 cost with insurance.

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Usually in the EOC they will stated that for you . Do you have your EOC?