In 2023, deductibles and co-pays will be the following:
| Deductible/Co-Pay | Amount |
|---|---|
| Calendar Year Deductible (limit of 3 per family) | $500 per individual |
| Facility Inpatient Co-Pay | $300 |
| Facility Outpatient Co-Pay | $300 |
| Emergency Room Facility Co-Pay | $300 |
| Primary Physician Co-Pay | $30 |
| Specialist Office Visit Co-Pay | $40 |
| Out-of-Pocket Maximum (Individual) | $9,100 |
| Out-of-Pocket Maximum (Family) | $18,200 |
Last updated: 10/18/2022
