UMP Classic

Out-of-pocket limit

Note: This definition applies to UMP CDHP only. See the definition for UMP Classic or UMP Plus.

The out-of-pocket limit is the maximum total amount you pay to your providers for covered services and prescription drugs during a calendar year.

The limit is $4,200 for one person on an account, or $8,400 if there is more than one person on an account. However, no individual may exceed $6,850 in covered out-of-pocket expenses annually.

Once you have reached this limit, the plan pays 100 percent of the allowed amount for covered services from preferred providers for the rest of the calendar year. See Out-of-pocket limit for what does and doesn’t count toward this limit.

Note: Your deductible does apply to this limit.