(up to 3)
| DEDUCTIBLE | COINSURANCE | OOP MAX |
|---|---|---|
| $5,000 | 100% | $6,600 |
(up to 3)
| DEDUCTIBLE | COINSURANCE | OOP MAX |
|---|---|---|
| $4,600 | 100% | $6,450 |
(up to 3)
| DEDUCTIBLE | COINSURANCE | OOP MAX |
|---|---|---|
| $2,000 | 100% | $5,000 |
(up to 3)
| DEDUCTIBLE | COINSURANCE | OOP MAX |
|---|---|---|
| $2,000 | 100% | $3,500 |
(up to 3)
| DEDUCTIBLE | COINSURANCE | OOP MAX |
|---|---|---|
| $3,500 | 100% | $6,000 |
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