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catastrophic limit |
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catastrophic limit Managed care A ceiling–eg $1000 on the amount of money that a person must pay out-of-pocket for the health care expenses incurred by a catastrophic illness–eg AIDS, burns, CA, MVA, etc, before the insurer
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But some schools purchase catastrophic limits of $1 million or $5 million. Once this catastrophic limit has been reached, Medicare payment for drugs resumes, and the beneficiary is only responsible for a copayment, which is 5% in most cases. Additionally, regional plans must have a catastrophic limit on out-of-pocket expenditures for in-network benefits and an additional catastrophic limit on total out-of-pocket expenditures for all benefits whether in-network or out-of-network. |
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