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The Out-of-Pocket Maximum

The Out-of-Pocket Maximum The out-of-pocket maximum is just what you’d expect from the name. It is the maximum of what you spend out-of-YOUR-pocket on the deductible, coinsurance and copayments (but not premiums or premium contributions). Once you reach the out-of-pocket maximum, the insurer pays 100% for in-network services for the rest of the year or benefit period. For non-Medicare plans, the out-of-pocket maximum is a combination of what you spend at the pharmacy and on medical services. For Medicare, medical and

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The Rules of Your Plan

The Rules of Your Plan Today’s featured topic is about the rules of one’s Plan. Please watch the video at healthcarenavigation.com/videos and spread the word so that others learn about this important topic. All coverage has rules one must follow in order for claims to be paid. The more restrictive plans have more rules so be particularly mindful of them if you are enrolled in an HMO or EPO product. The following are rules to understand: Primary Care Physician (PCP): Know