All-Inclusive Out-of-Pocket Limit Increases Effective January 1, 2026 to Limits Established Annually Under the Affordable Care Act

The All-Inclusive Network Out-of-Pocket Limit sets the maximum amount you pay out of pocket per calendar year for network benefits under the Health Plan, including deductibles, co-insurance and co-payments (including prescription drug co-payments, the $50 emergency room co-payment and the $10 co-payment for visits to the UCLA/EIMG health clinics).

The Health Plan evaluates this limit annually to ensure that it remains appropriate for the current economic climate and is in line with the amount established each year under the Affordable Care Act.

Accordingly, beginning January 1, 2026, the Health Plan’s All-Inclusive Network Out-of-Pocket Limit will increase from $9,200 per individual/$18,400 per family to $10,600 per individual/$21,200 per family for all coverage plans. Once you reach the limit, the Health Plan will pay 100% of covered network expenses.