Family Deductible Progress

Track embedded individual expenses toward a family deductible.

Description

Family deductible progress can cap each member’s eligible expense at an individual deductible, then cap their sum at a family deductible.

Family deductible progress can cap each member’s eligible expense at an individual deductible, then cap their sum at a family deductible.^[1]

Track embedded individual expenses toward a family deductible.

When to use Family Deductible Progress

Use this tool to track embedded individual expenses toward a family deductible.

Prepare the supplied policy terms, dates, assumptions or recorded indicators requested. Keep monetary amounts on one currency basis and select the applicable thresholds separately.

How to use Family Deductible Progress and understand its results

Prepare the supplied policy terms, dates, assumptions or recorded indicators requested. Keep monetary amounts on one currency basis and select the applicable thresholds separately.
Enter familyDeductible, individualDeductible, memberEligibleExpenses using the field table and calculation rules, then run the tool.
Read memberAppliedAmounts, familyAppliedAmount, familyRemaining, familyDeductibleMet. The explanation below defines the units, signs, ordering and any flags or placeholder values.
If the tool reports an input issue, correct the values and run it again. Apply the stated assumptions when interpreting a successfully returned result.

Input field	Meaning	Value type; see rules below	Requirement
familyDeductible	Family deductible	number; minimum: 0	Required
individualDeductible	Embedded individual deductible	number; minimum: 0	Required
memberEligibleExpenses	Eligible expenses by member	list of number	Required

Enter nonnegative deductibles and expenses. Empty expenses are allowed. Return member amounts, family applied/remaining and inclusive met flag; zero family deductible is met. Member amounts are not reallocated when their sum exceeds the family cap.

memberApplied_i=min(expense_i,individual); familyApplied=min(family,ΣmemberApplied)

Units, indexing, boundary conditions and exceptional cases are defined in the calculation rules above.

Output field	Meaning	Value type
memberAppliedAmounts	Amounts applied by member	list of number
familyAppliedAmount	Total applied to family deductible	number; minimum: 0
familyRemaining	Family deductible remaining	number; minimum: 0
familyDeductibleMet	Family deductible met	boolean

json

{
  "input": {
    "familyDeductible": 3000,
    "individualDeductible": 1500,
    "memberEligibleExpenses": [
      2000,
      1000
    ]
  },
  "output": {
    "memberAppliedAmounts": [
      1500,
      1000
    ],
    "familyAppliedAmount": 2500,
    "familyRemaining": 500,
    "familyDeductibleMet": false
  }
}

Limitations and assumptions

No plan interpretation, claim adjudication, prior progress or benefit payment is supplied.

Numeric inputs must be finite. Follow the calculation-specific rules for overflow, underflow and exceptional cases. Lists are limited to 100,000 entries; the rules above may require smaller limits. Missing required fields, extra fields, wrong value types and violations of the calculation rules are input errors. A successfully returned false flag is an evaluated outcome; its meaning is explained above.

Alternative or Complementary methods

Use HSA Deductible Screen: Compare plan figures with caller-supplied HSA thresholds. For a complementary task, use Out-of-Network Balance: Separate recognized cost share from a potential out-of-network balance bill.

References

Family Deductible Progress — tool.io

Similar or alternative tools

HSA Deductible Screen
Compare plan figures with caller-supplied HSA thresholds.
Out-of-Network Balance
Separate recognized cost share from a potential out-of-network balance bill.