out-of-pocket maximum
Insurance payment cap
The out-of-pocket maximum is the most you'll pay for covered healthcare expenses in a year under an insurance plan.
Once you've spent that amount on deductibles, copays, and coinsurance, your insurance covers 100% of remaining costs for the rest of the year.
After hitting her out-of-pocket maximum in July, her chemotherapy was fully covered.
- copaymentPatient's fixed healthcare charge
- high deductibleSteep initial self-payment
- preauthorizationPermission obtained beforehand
- financial protectionSafeguard against monetary loss
- surprise billingUnforeseen out-of-network charges
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