For the first time, your Relief PPO medical plan has a cap on your annual out-of-pocket costs. For those facing extensive health care needs, this is a huge help.
As of July 1, 2014, the most you’ll have to pay during this calendar year for in-network, out-of-pocket costs is $6,350 for individuals and $12,700 for families. Having a maximum DOES NOT mean you have to pay those amounts first before the plan kicks in; it means all co-pay and deductible amounts apply toward the out-of-pocket maximum and once it has been reached, the Plan pays 100% for the remainder of the year for eligible expenses.
Of course, your plan already covers most in-network services at 100% or a minimal $15 co-pay. Most people never even come close to spending the above out-of-pocket costs. But in the event of a serious illness, injury or need, the plan now has built-in protections to limit your financial burden.