Plan says no charge after deductible, but has an Out-ofPocket Maximum?

I’m a bit confused about an HSA plan I want to sign up for through my work. The plan is a high deductible HSA EPO through Oxford- United Healthcare. The deductible is $1600, and the sheet they gave me says that everything (Outpatient Care, Emergency Care, Hospital Care, Scans, etc.) is “No Charge After Deductible.” The only exception is medication, which still has a co-pay.

However, what I’m confused about is that it still says there is an out-of-pocket maxiumum of $3200. I guess where I’m confused is, how could I reach that OOP Maximum if everything is covered after ther $1600 deductible? Why would it be on there? Is there something I’m missing?

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I’d guess the out-of-pocket max applies to out-of-network care, or there are some services that aren’t fully covered after the deductible.

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My first thought was the out of network thing as well, but I wasn’t sure that would be possible. But thank you for the suggestion! I’d like to see a full EoB but it’s telling me I can only do so after I sign up for the plan, when I get the Coverage Agreement.

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The medication copays go towards that max out of pocket.

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I like UHC depending on how good the network in your location. I don’t like EPOs and I try to have as much flexibility in choosing a provider as possible.

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Going OON, even with a PPO is crazy :thinking:

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It only makes sense if you have UCR reimbursement, not 150% of Medicare. That said, a plan like that starts at about $1,200 a month in my area.

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I’ve never had to go out-of-network (OON), and very few claims from my groups have been OON. The few that were happened with a large group, and the carrier wanted to keep the case, so they paid as in-network. The provider accepted the payment as full.

Aetna had the cheapest quotes, but their network was so small that we only had one case with them, and we moved it at renewal.

EPOs and HMOs around here also have restrictions beyond the network.

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That’s interesting! I’m in TX and have never had a complaint on Aetnas CPOSII or OAAS network, but I know they’re much more localized than the other BUCAs

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You will still be responsible for copays after hitting your deductible until you hit your OOPM