Glossary: Out of Pocket Maximum
The most you pay during a policy period (usually 1 year) before your health insurance starts to pay 100%. This limit includes deductibles, co-pays, co-insurance, and other similar expenses you pay.
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Transcript: Out of pocket maximum: The most you pay during a policy period (usually 1 year) before your health insurance starts to pay 100%. This limit includes deductibles, co-pays, co-insurance, and other similar expenses you pay. For example, if your out of pocket maximum is $5,000 and you've paid expenses throughout the year and reach $5,000 before the year ends, your health insurance will cover 100% of any cost for services. When the policy period ends, the balance starts over at $0 for you to build up to $5,000 again.
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