The Annual Out-of-Pocket Maximum
Under the Expatriate Medical Plan, the annual out-of-pocket maximum is the maximum amount you must pay in medical expenses in a plan year toward eligible expenses, once the deductible has been met. The annual out-of-pocket maximum does not include the deductible and there are separate out-of-pocket maximums for out-of-network charges incurred in the U.S. The annual out-of-pocket maximum functions as your built-in "safety net" and protects you from having to pay high expenses in the event of a serious medical situation. Once the out-of-pocket maximum is reached, the Expatriate Medical Plan will pay 100% of negotiated fees for covered in-network care and 100% of reasonable and customary charges for covered services received out-of-network in the U.S. and outside the U.S. for the remainder of the year. Amounts you pay toward your deductible, copayment amounts, and amounts above reasonable and customary charges do not count towards your out-of-pocket maximum.
The following table shows the out-of-pocket maximums (excluding deductibles) for the different coverage levels.