Joe only pays for the medical care he uses. That is the most Joe will pay this year out of his own pocket for covered medical expenses. Joe’s plan has a $8,700 out-of-pocket maximum. Remember, if you go out of your network for services, those expenses may not count toward your OOPM, and you could have to pay more.With a Blue Advantage Gold HMO Plan, your OOPM will be even lower.
#Out of pocket maximum plus#
If you selected a Blue Advantage Bronze HMO Plan or Blue Advantage Plus Bronze HMO Plan, your OOPM will be $7,000 per individual.
For 2022, the highest OOPM a plan can have is $8,700 for an individual and $17,400 for families. The government can change the OOPM each year.This limit protects you if serious and expensive medical issues come up. Your OOPM limits how much you can be charged for your health care expenses.If you are a current BCBSIL member, you can see your plan’s OOPM in Blue Access for Members SM. It’s different for every type of plan. And it is the most you’ll have to pay during a policy period – usually a year – for health care services. It’s called your out-of-pocket maximum (OOPM). But here’s some good news: There is a limit to how much you are required to pay. You pay money to cover your deductible, coinsurance and copays. You share the cost of your care with your health insurance company. One you’re sure to run across is “out-of-pocket maximum.” What does it mean? How does it affect you and your family? How does it influence your choice of health plan? We know health care terms can be confusing.
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