What does Total Policy Year Maximum mean in the Access Plan?

The Total Policy Year Maximum is the total amount your Access Plan will pay in Benefit Amounts for covered medical costs within one year. You can choose a Total Policy Year Maximum between $5,000 and $2 million for the base Access Plan. For example, if you have a Total Policy Year Maximum of $25,000, your base Access Plan will pay the Benefit Amounts for medical care up to $25,000.

For Members with a $2 Million Total Policy Year Maximum: As an added feature, if you select $2 million Total Policy Year Maximum, after your Access Plan has paid $10,000 in benefits, your Benefit Amount for each covered service will increase by 25%, as will be shown in the Sidecar Health member portal, available at member.sidecarhealth.com, when you look up your Benefit Amount.

In some states, an optional Maternity Care Rider is available which has its own Total Policy Year Maximum that applies only to maternity and newborn medical services not otherwise covered by the base Access Plan.