2026 Medical Plans FAQ
Key Terms
The out-of-pocket maximum (OOPM) is the highest amount you'll pay for covered medical services in a year. Once you reach this limit, the plan will cover 100% of the remaining covered costs for the rest of the year.
The out-of-pocket maximum includes your deductible, copayments, and coinsurance. There is a separate out-of-pocket maximum for pharmacy benefits.
A deductible is the amount you pay out-of-pocket for covered services before your medical plan starts paying its share. Deductibles do not apply to in-network preventive care services. These services are covered 100% by your medical plan.
What accounts can help me pay for deductibles?
- For the PPO Plans: Flexible Spending Account (you contribute tax-free)
- For the CDHP with HSA Plan: Health Savings Account (HSA; you can contribute tax-free, and Brown provides a contribution to help cover your deductible)
Coinsurance is the percentage of medical bill costs you pay after you've met your medical plan's deductible. You stop paying coinsurance when you’ve met your out-of-pocket maximum.
What are copays versus coinsurance?
Copays are fixed amounts you pay for certain services, while coinsurance is a percentage of the bill. For example, you might pay a copay for a doctor's visit, and then coinsurance for the cost of tests or procedures ordered during that visit.
2026 Medical Plan Changes
Action(s) For You
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