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Help for question 3
How much is/are the plan's out-of-pocket limits?
Where to look
You will see:
- "Is there an out-of-pocket limit on my expenses?" and
- "What is not included in the out-of-pocket limit?"
under "Important Questions" on the Summary of Benefits and Coverage.
Only look at amounts for a single person (or individual) using a preferred (or in-network) provider.

How to answer
If you see |
Answer like this: |
---|---|
Only one out-of-pocket limit (no separate out-of-pocket limit for prescription drugs) |
Fill out A. Skip B1 and B2. Go to Question 4. |
An out-of-pocket limit and a separate out-of-pocket limit for prescription drug coverage |
Skip A. Fill out B1 with the medical out-of-pocket limit. Fill out B2 with the prescription drug out-of-pocket limit. Go to Question 4. |