BNY Mellon Benefits Guide
Know When Your Deductible Applies
The deductible is the amount you pay for medical services before BNY Mellon will begin to share the cost of care. Use this chart as a guide to understand when your deductible applies.
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SERVICE TYPE
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DEDUCTIBLE APPLIES
|
DEDUCTIBLE DOES NOT APPLY
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|
Preventive Care Office Visit
Routine physicals (adult and child), mammograms, well childcare (immunizations)
|
√
(out-of-network)*
|
√
Covered at 100%
(in-network only)*
|
|
Diagnostic Care Office Visit
Family/general practice, internal medicine, pediatrician, ob/gyn
|
√
|
|
|
Mental Health, Behavioral Health and Substance Abuse
Inpatient and outpatient services
|
√
|
|
|
X-rays, Blood Tests, Outpatient Tests
|
√
|
|
|
Outpatient Surgery
|
√
|
|
|
Hospital Care
|
√
|
|
|
Emergency Room/Urgent Care Centers
|
√
|
|
|
Physical, Speech and Occupational Therapy
|
√
|
|
|
Preventive Prescriptions
|
|
√
|
|
Non-Preventive Prescriptions
|
√
|
|
* Out-of-network preventive covered at 60 percent after deductible.
