U.S. Expatriate Resident
Outside U.S.In-Network U.S.Out-of-Network U.S.
Annual Out-of-Pocket Maximum: The maximum you will pay in a plan year
Individual$1,500$2,000$4,000
Family$2,500$4,000$8,000
Coinsurance: The portion of the cost paid by Transocean*
Transocean pays:80% or 100% of eligible charges80% of eligible charges60% of eligible charges
Preventive Care: Annual exams, immunizations, and screenings
Transocean Pays:100% of eligible charges100% of eligible charges100% of eligible charges
Outpatient Medical Services: Pre-certification required
Physician Fees80% of eligible charges80% of eligible charges60% of eligible charges
Emergency Care100% of eligible charges
Ambulance100% of eligible charges
Lab Testing80% of eligible charges80% of eligible charges60% of eligible charges
X-Ray & MRI80% of eligible charges80% of eligible charges60% of eligible charges
Hospitalization: Pre-certification required
Hospital room and board100% of eligible charges80% of eligible charges60% of eligible charges
Physician and Surgery Fees100% of eligible charges80% of eligible charges60% of eligible charges
Mental, Nervous and Substance Abuse: Pre-certification required
Inpatient100% of eligible charges80% of eligible charges60% of eligible charges
Outpatient80% of eligible charges80% of eligible charges60% of eligible charges
Skilled Care: Pre-certification required, limited to 60 days per calendar year
Skilled Nursing Facility100% of eligible charges80% of eligible charges60% of eligible charges
Home Healthcare100% of eligible charges80% of eligible charges60% of eligible charges
Short-Term Rehabilitation100% of eligible charges80% of eligible charges60% of eligible charges
Prescription Drugs
Transocean Pays:80% of eligible charges80% of eligible charges60% of eligible charges
Vision Care
Vision Exam80% of eligible charges, one exam per calendar year
Frames, lenses, contacts or LASIK80% of eligible charges, up to $300 annual maximum
Safety glasses$150 per calendar year allowance

*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 coinsurance reimbursements are based on Reasonable & Customary rates.