WHAT IS THE OUT-OF-POCKET LIMIT?

The out-of-pocket limit is the most you could pay in a year for covered services.

● $500 PSF Health = $1,000 per person per calendar year and/or $500 PSF Drug Rx = $1,000 per person per calendar year

■ Deductible and out-of-pocket maximum amounts you pay for covered prescription drugs under Blue Rx Value Plus apply toward the Alliance Select medical deductible and out-of-pocket maximum. Likewise, deductible and out-of-pocket maximum amounts you pay for covered medical services under Alliance Select also apply toward the Blue Rx Value Plus deductible and out-of-pocket maximum.

● $2500 PSF HDHP = $2,500 per person per calendar year

● $5000 HDHP = $5,000 per person per calendar year