Charges & Financial Obligations · Restriction or exception
Usual deductible, copay or coinsurance still applies; ask the plan administrator for details
The notice says the member will pay their usual deductible, copay, and/or coinsurance for these benefits and should contact their plan administrator for details. It does not give amounts.
Supporting quotations
You’ll pay your usual deductible, copay, and/or coinsurance. For details, contact your plan administrator.
Qualifications & exceptions
- Cost sharing is the member's usual deductible, copay and/or coinsurance.
Not stated here
- Amounts are not stated, and the plan administrator is not named.