Premiums, balance-billed charges, payments for What is not included in the services subject to a maximum once you reach the maximum, any amounts you owe in addition Even though you pay these expenses, they don’t count toward the out-of-pocket out-of-pocket limit? to your copayment for covered services, and limit. [...] You will pay the most if you use an out-of-network provider, and you Will you pay less if you use a network provider? or call 1-800-776-4672 for a list of network might receive a bill from a provider for the difference between the provider’s charge providers. [...] This plan will pay some or all of the costs to see a specialist for covered services see a specialist? but only if you have a referral before you see the specialist. [...] Please refer to your plan limited to services covered by this medical plan document for limitations and additional details) and within the scope of a chiropractor's license) Your Rights to Continue Coverage:There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is: 1) 1-800-776-4672 for HMSA; 2) (808) 586-2790 for the Stat. [...] Does this Coverage Meet the Minimum Value Standard? Yes If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
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- United States of America
