Out-of-Pocket Maximum
The most you will have to pay for covered services in a plan year. Once you hit this amount through deductibles, copays, and coinsurance, your insurer pays 100% of covered costs for the rest of the year. This cap protects you from catastrophic medical expenses.
Real-World Example
With an out-of-pocket maximum of $6,000, once Alex has spent that much on deductibles and coinsurance during the year, his health plan covers everything else at 100%.
Related Terms
Disclaimer: This glossary entry is for informational purposes only and does not constitute financial or insurance advice. Consult with a licensed insurance professional for personalized guidance. GuardianChoices may earn affiliate commissions from links on this site — see our advertiser disclosure.
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