Health
Out-of-Pocket Maximum
The most you'll pay in a year for covered health care before insurance pays 100%.
What it actually means
Once your combined deductible, copays, and coinsurance for the year hit this cap, your health plan covers 100% of covered services for the rest of the plan year. It's the ceiling on your financial exposure — the number that matters most in a genuinely bad year.
Example: If your plan's out-of-pocket max is $6,000 and you hit it by August after a surgery, every covered visit for the rest of the year costs you $0.
See it in context
Run the free Insurance Coverage Blueprint to see how out-of-pocket maximum and terms like it apply to your specific situation — no signup required.