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If a consumer has exceeded his or her annual out-of-pocket expenses, does the patient still have co-insurance or co-pay obligations for the O&P benefit?

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If a consumer has exceeded his or her annual out-of-pocket expenses, does the patient still have co-insurance or co-pay obligations for the O&P benefit?

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No. Out-of-pocket expenses for basic medical services now include payments for O&P benefits. If the annual amount has been reached by the consumer, additional out-of-pocket payments can not be collected for the O&P benefit.

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