Please Note: This information is a general reference tool. All terms, conditions and amounts may not be applicable to your benefit plan. Please refer to your Plan Document for a complete listing of terms, conditions, coverage and exclusions of your benefit plan.
Terms Beginning with the Letter "O"
Out of Pocket Limit is the amount at which Covered Charges incurred by a Covered Person will be payable at 100% (except for the charges excluded) for the rest of the Benefit Year. Covered Charges are payable at the percentages shown each Benefit Year until the out of pocket limit shown in the Schedule of Benefits is reached for that Benefit Year.
Outpatient Care and/or Services is treatment including services, supplies and medicines provided and used at a Hospital under the direction of a Physician to a person not admitted as a registered bed patient; or services rendered in a Physician's office, laboratory or X‑ray facility, an Ambulatory Surgical Center, or the patient's home.
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