Leash, they have put a cut off amount on certain things.... IVF, IUI, Assisted Conception & Obstetrics.
Its just a flat amount of approx $500. (So as far as I understand it, no gap plus a percentage of OOP... just a flat rate).

For example, if I were to do an IVF cycle this year (say I'd passed my threshold) - before where we used to pay $6500 for a cycle, we'd get back roughly $5000. (Normal medicare gap plus 80% of OOP)
Now, regardless of what the cycle will cost us, we only get back a set amount (I think its about $482 )

So although you guys may have reached your limit, you won't necessarily get back the 80% (unless the 80% is roughly what the set amount is).. god, does any of that make sense?!

I think that is per cycle, not a once only for the year... but I really don't know for sure

Geeez, what a jibberish post