To better understand the coverage provided under the EPO option, it’s important to understand these key terms.
To better understand the coverage provided under the EPO, it’s important to know these key terms.
The deductible is a specified annual dollar amount you must pay for covered medical services before the plan begins to pay benefits.
A copay is a flat dollar amount that you pay upfront for certain services when using network providers.
A copayment is the percentage of the plan allowance for covered services that you pay after meeting the deductible:
The combined maximum out-of-pocket is a specified annual dollar amount you pay for covered medical and prescription services, after which the plan pays 100 percent of allowable costs for the rest of the year.
The EPO combined maximum out-of-pocket amounts are shown on the Key Provisions chart.
Expenses that count toward the EPO combined maximum out-of-pocket include your deductibles, office visit copays, copayments, and prescription drug copays.