Close but not quite correct. In your above example your first appointment would cost you $200 to satisfy your son's individual deductible then 20% co-insurance on the remaining balance so an additional $60. The second appointment would be $100 total, or 20% of the balance. Any combination of payments totaling $2500 for all your covered family members would leave any covered procedures at $0 for the rest of the calendar year for all of you. Prescription drug charges are also included in your deductibles and out of pocket maximums, there is not a separate pot of money for them.