Copayments and annual out-of-pocket maximums Sample Clauses
The "Copayments and annual out-of-pocket maximums" clause defines the insured individual's financial responsibilities for covered healthcare services, specifically the fixed amounts (copayments) paid at the time of service and the maximum total amount they must pay in a year (out-of-pocket maximum). Typically, this clause outlines which services require copayments, how much those payments are, and clarifies that once the annual out-of-pocket maximum is reached, the insurance plan covers 100% of additional eligible expenses for the remainder of the year. Its core function is to provide predictability and limit the financial burden on the insured by capping their total yearly healthcare costs.
Copayments and annual out-of-pocket maximums. For the first and second year of the contract:
Copayments and annual out-of-pocket maximums. For the first and second year of the contract: Tier 1 copayment: Eighteen dollar ($18) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply.
Copayments and annual out-of-pocket maximums. For each year of the contract: Tier 1 copayment: Ten dollar ($10) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty (30) day supply. Tier 2 copayment: Sixteen dollar ($16) copayment Per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 copayment: Thirty-Six dollar ($36) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out-of-pocket maximum: There is an annual maximum eligible out of-pocket expense limit for prescription drugs of eight hundred dollars ($800) per person or one thousand six hundred dollars ($1,600) per family.
Copayments and annual out-of-pocket maximums. For the first and second year of the Contract: Tier 1 co-payment: Twelve dollar ($12.00) copayment per prescription or refill for a Tier 1 drug dispensed in a thirty day (30) supply. Tier 2 co-payment: Eighteen dollar ($18.00) copayment per prescription or refill for a Tier 2 drug dispensed in a thirty (30) day supply. Tier 3 co-payment: Thirty-eight dollar ($38.00) copayment per prescription or refill for a Tier 3 drug dispensed in a thirty (30) day supply. Out-of-pocket maximum: There is an annual maximum eligible out-of-pocket expense limit for prescription drugs of eight hundred dollars ($800.00) per person or one thousand six hundred dollars ($1,600.00) per family.
Copayments and annual out-of-pocket maximums. 4 For each the first year of the contract: 6 Tier 1 copayment: Ten dollar ($10) copayment per prescription or refill for a Tier 7 1 drug dispensed in a thirty (30) day supply. 9 Tier 2 copayment: Sixteen dollar ($16) copayment per prescription or refill for a 10 Tier 2 drug dispensed in a thirty (30) day supply. 12 Tier 3 copayment: Thirty-six dollar ($36) copayment per prescription or refill for
13 a Tier 3 drug dispensed in a thirty (30) day supply. 15 Out-of-pocket maximum: There is an annual maximum eligible out-of-pocket 16 expense limit for prescription drugs of eight hundred dollars ($800) per person or 17 one thousand six hundred dollars ($1,600) per family. 19 For the second year of the contract: 21 Tier 1 copayment: Twelve dollar ($12) copayment per prescription or refill for a 22 Tier 1 drug dispensed in a thirty (30) day supply. 24 Tier 2 copayment: Eighteen dollar ($18) copayment per prescription or refill for 25 a Tier 2 drug dispensed in a thirty (30) day supply. 27 Tier 3 copayment: Thirty-eight dollar ($38) copayment per prescription or refill 28 for a Tier 3 drug dispensed in a thirty (30) day supply. 2 Out of pocket maximum: There is an annual maximum eligible out-of-pocket 3 expense limit for prescription drugs of eight hundred dollars ($800) per person or 4 one thousand six hundred dollars ($1,600) per family.