Does the out-of-pocket maximum for in- and out-of-network service commingle?
With Plans 3 through 8, services accumulated toward the in-network out-of-pocket maximum can be used to satisfy both the in- and out-of-network out-of-pocket maximum. However, services accumulated toward the out-of-network out-of-pocket maximum cannot be used to satisfy the in-network, out-of-pocket maximum. With Plan 9, a Health Savings Account (HSA)–compliant plan, services accumulated toward both the in- and out-of-network out-of-pocket maximums can be used to satisfy both the in- and out-of-network out-of-pocket maximums.
Related Questions
- Can you clarify the difference between the Annual Deductible vs. Out-of-Pocket Maximum in the POS Out-of-Network coverage?
- Do out-of-network charges count towards the deductible and out-of-pocket maximum for the BCBS Low and High plans?
- Does the maximum Out-Of-Pocket expense of $5,500 for individuals and $11,000 for families include the deductible?
