Deductibles, coinsurance and total out-of-pocket maximums for HealthSelect of Texas® plans reset on January 1, 2020.
The coinsurance out-of-pocket maximum is the most you’ll pay in coinsurance during the year for certain health care services. The total out-of-pocket maximum is the most you’ll pay during the calendar year in coinsurance and copays for covered in-network health care services and prescription drugs. After you meet this limit, the plan will pay 100% of the allowed amount for in-network covered services. If you pay premiums for dependent coverage, those are not included in the out-of-pocket maximum amount.
Keep in mind, there are new total out-of-pocket maximums for the 2020 plan year. The 2020 total out-of-pocket maximums are $6,750 for individuals and $13,500 for families. For additional benefit details on your specific medical plan, refer to the Medical Benefits Guide.
If you’d like a refresher on more health care terms, visit this glossary of health care terms. You can also find more information by reading the Insurance 101: Understanding Your Medical Plan article. For questions, contact Blue Cross and Blue Shield of Texas Personal Health Assistant toll-free at (800) 252-8039, Monday – Friday 7 a.m. – 7 p.m. and Saturday 7 a.m. – 3 p.m. CT.