What I Need to Know

Once the out of pocket maximum and deductible has been met in full for the year, one would expect that ALL covered services, treatment and supplies would be paid at 100%. 

This is not the case for all plans, so depending on how the plan is written a patient may still be required to pay a copay even if the plan is paying at 100%.  

Some plans have a separate copay maximum that will waive all future copays once a stated dollar amount has been reached, while others will require that the copay be paid for all visits. 

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