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What is Out-of-Pocket Maximum?
The out-of-pocket maximum is the most you'll pay in a policy year for covered services before insurance covers 100%. It usually includes deductibles, copays, and coinsurance, but not premiums.
Examples
- A $9,000 individual out-of-pocket max caps your annual exposure on covered services.
- Family plans typically have a higher combined out-of-pocket max.
- Out-of-network care often doesn't count toward the in-network max.
Why this matters
ReadMyPolicy shows your worst-case annual cost in plain English — the number most plan summaries bury three pages deep.
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