Please be sure to enter your Member ID WITHOUT
the NSA prefix—only the numbers, no letters.
Please be sure to enter your Member ID WITHOUT
the NSA prefix—only the numbers, no letters.
Comprehensive Out-of-pocket Maximum |
||
---|---|---|
In-network | Out-of-network | |
Plan I (Active Plan) |
$8,550/person; |
No maximum |
Plan II* |
$8,550/person; |
No maximum |
The comprehensive out-of-pocket maximum is the maximum amount you could pay in any calendar year — including all Copays, Coinsurance and Deductibles — for Hospital, medical, prescription drugs, mental health and substance abuse services from In-network Providers under the Plan. There is no comprehensive out-of-pocket maximum for out-of-network care. The Plan's comprehensive out-of-pocket maximum is set in accordance with the Affordable Care Act (ACA) and updated annually.
*Note: Plan II runs out September 30, 2021