All-Inclusive Out-of-Pocket Limits Increase, Effective January 1, 2021 as Established Under the Affordable Care Act

The All-Inclusive Network Out-of-Pocket Limit sets a maximum on the amount you pay out of pocket per calendar year for network benefits, including deductibles, co-insurance and co-payments (such as prescription drug co-payments, the $50 emergency room co-payment and the $10 co-payment for visits to the UCLA/MPTF health centers). The Health Plan indexes this limit annually, in line with the amount established each year under the Affordable Care Act.

Accordingly, beginning January 1, 2021, the Health Plan’s All-Inclusive Network Out-of-Pocket Limit will increase from $8,150 individual/$16,300 family to $8,550 individual/$17,100 family for all coverage plans. If you reach the limit, the Health Plan will pay 100% of covered network expenses.