This is the most you pay per plan year for covered health expenses before the plan pays 100 percent of covered expenses for the rest of the year.
Log in to MyBlue to see how much you've spent toward your out-of-pocket maximum.
Your out-of-pocket maximum is $3,400 in-network or $5,100 for combined in- and out-of-network medical services each calendar year.
A copayment is the cost you're required to pay for certain services or prescription drugs.
Your in-network copayments are:
Doctor's office visit: $25 per visit
Inpatient hospital care: $150 per day (days 1-5), $0 per day (after day 5), $750 annual out-of-pocket maximum
Emergency room: $65 per visit (waived if admitted or for observation stay)
Prescription drugs: $10-70
Co-insurance is the percentage of costs that you pay, or "share," for some out-of-network services.
Your out-of-network co-insurance is 20 percent.
Active Employees & non-Medicare eligible Retirees
