Expatriate ResidentExpatriate Commuter & Expatriate Resident Commuter
Annual Out-of-Pocket Maximum: The maximum you will pay in a plan year
Individual$1,500$1,500
Family$2,500$2,500
Coinsurance: The portion of the cost paid by Transocean**
Transocean pays:80% or 100% of eligible charges80% or 100% of eligible charges
Preventive Care: Annual exams, immunizations, and screenings
Transocean pays:100% of eligible charges100% of eligible charges
Outpatient Medical Services: Precertification required, medical care that does not require an overnight stay
Physician Fees80% of eligible charges80% of eligible charges
Emergency Care100% of eligible charges100% of eligible charges
Ambulance100% of eligible charges100% of eligible charges
Lab Testing80% of eligible charges80% of eligible charges
X-Ray & MRI80% of eligible charges80% of eligible charges
Hospitalization: Pre-certification required
Hospital room and board (semi-private)100% of eligible charges100% of eligible charges
Physician and Surgical Fees100% of eligible charges100% of eligible charges
Mental, Nervous and Substance Abuse: Pre-certification required
Inpatient100% of eligible charges80% of eligible charges
Outpatient80% of eligible charges80% of eligible charges
Skilled Care: Pre-certification required, limited to 60 days per calendar year
Skilled Nursing Facility100% of eligible charges80% of eligible charges
Home Healthcare100% of eligible charges80% of eligible charges
Short-Term Rehabilitation100% of eligible charges80% of eligible charges
Prescription Drugs
Transocean pays:80% of eligible charges80% of eligible charges
Vision Care
Vision Exam (one per calendar year)80% of eligible charges80% of eligible charges
Frames, lenses, contacts or LASIK
80% of eligible charges
$300 Annual Maximum
80% of eligible charges
$300 Annual Maximum
Safety Glasses$150 per calendar year allowance80% of eligible charges

*Emergency care within the US for non-US citizens will be covered at 80% of eligible charges with out-of-pocket maximums of $2,000/$4,000.

**Coinsurance is the amount that the employee owes after the deductible has been met. This chart reflects Transocean's portion of the coinsurance amount.

All reimbursements are based on Reasonable & Customary rates; pre-certification is required in most cases.

US citizens on International Commuter coverage will be covered at 80% of eligible charges up to specified out-of-pocket maximums, contact MSH for plan specifics.

Services listed are an example of coverage under the plan, for plan specifics see Plan documents.

Service specific limits may apply, for plan specifics see Plan documents.