Documentation:

* If COINSURANCE & DEDUCTIBLE  

DEDUCTIBLE is NOT YET MET

(For ANTHEM only $85 will be collected)

> Will collect $70 towards deductible per visit. Once deductible is met will collect ___ coinsurance until OOP max met

DEDUCTIBLE IS MET

> Deductible is met, will collect __ coinsurance per visit until OOP max met.
OOP MAX MET (regardless if deductible is met or not met)

> Individual deductible is met, will collect __ coinsurance per visit until OOP max met.

> Family deductible is met, will collect __ coinsurance per visit until OOP max met.

OOP MAX MET (regardless if deductible is met or not met)

> OOP max is met, insurance will cover 100%

> Individual OOP max is met, insurance will cover 100%

> Family OOP max is met, insurance will cover 100%

* COPAY only

 OOP MAX is NOT MET

> Will collect $__ copay until OOP max met.

OOP MAX MET

> OOP max is met, insurance will cover 100%

> Individual OOP max is met, insurance will cover 100%

> Family OOP max is met, insurance will cover 100%