Please note that the out-of-pocket examples you are about to review are examples only and intended for Employees and Retirees Under Age 65 residing in Texas. The billed and allowable amounts for your care will differ from the amounts shown in these examples.
Also note that all participants have a coinsurance out-of-pocket maximum. This is a dollar maximum that a participant will pay in coinsurance in a calendar year before HealthSelect will begin paying at 100% of the allowable amount. The coinsurance out-of-pocket maximum does not include any copayments or charges over the BCBSTX allowable amount.
Coinsurance out-of-pocket maximum amounts are accumulated in the order your claims are processed. The examples you are about to review do not take into consideration any amounts that you may have already paid toward your coinsurance out-of-pocket maximum.
