Member (postdoc) will be required to make certain Copayments for Covered Benefits as specified in the Schedule of Benefits. Copayments must be paid at the time the Covered Benefits are rendered. The total aggregate amount of Copayments a Member is required to pay per year for basic services is specified in the Schedule of Benefits.
Member will also be responsible for any charges made by Participating Providers for scheduled appointments that are missed without notice to the Participating Providers or without good cause. Personal administrative service costs such as copying Member medical records or completing forms for school, camp, employment, etc. are also Member’s responsibility.
Maximum Out-of-Pocket Limit
If a Member’s Copayments reach the Maximum Out-of-Pocket Limit set forth on the HMO Schedule of Benefits, HMO will pay 100% of the contracted charges for Covered Benefits for the remainder of that calendar year. Covered Benefits must be rendered to the Member during that calendar year.