26 shown in the Schedule of Benefits, all further covered charges for all covered family members will be paid by the Plan at 100% for the remaining months of that calendar year. For this purpose, the term family includes you, your Spouse, and your Eligible Dependent Children who are covered under the Plan. The above provisions do not apply to charges that exceed Usual, Customary and Reasonable (UCR) charges, charges that exceed Plan benefit limitations, or charges for services that are excluded under the terms of the Plan. Accumulation of Deductible and Out - of - Pocket Limits Covered expenses incurred either in - network or out - of - network will cross accumulate to satisfy deductible amounts and maximum out - of - pocket limits. However, note that separate out - of - pocket limits apply to in - network and out - of - network cov ered medical charges and Prescription Drug Coverage. Lifetime Maximum The Plan does not impose an overall lifetime dollar maximum. However, there are limits that may apply for some types of visits, and/or a limit on the number of days permitted for the be nefit under the terms of the Plan. In addition, there may be dollar limits applicable to certain benefits as described in this SPD.

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