Page 11 - MM365+

Helpful Information about Deductibles and Out-Of-Pocket Maximums
[When electing coverage for any family members in addition to yourself, deductibles and out-of-pocket maximums are applied differently for different plans.]
PLAN
DEDUCTIBLE
OUT-OF-POCKET MAXIMUM
[Insert Aggregate/Non- Embedded/True Family Plans]
The entire Family Deductible must be met before benefits begin to pay out for any family member
The entire Family Out-of-Pocket Maximum must be met before the plan pays in full for any family member
[Insert Embedded/Non- True Family Plans]
Once one family member meets the Individual Deductible, benefits begin to be paid for that individual
Once one family member meets the Individual Out-of-Pocket Maximum, the plan pays covered benefits in full for that individual
[Insert Kaiser California Plans]
Once one family member meets the Individual within Family Deductible, benefits begin to be paid for that individual
Once one family member meets the Individual within Family Out-of-Pocket Maximum, the plan pays covered benefits in full for that individual
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