What you pay goes toward your deductible first. Deductible: The deductible is how much you are expected to pay per year for medical services your plan covers. Out-of-pocket maximum: Those post-deductible charges add up, which is where the out-of-pocket maximum comes in. Depending on your plan, any one of the following scenarios may apply to you:.
If you have a high-deductible health plan , your deductible may be as high as your out-of-pocket maximum, making you eligible for a health savings account. Obamacare also requires the federal government to set annual limits on out-of-pocket maximums that apply to every health plan sold in America.
There are different out-of-pocket maximums for individuals and family plans that have two or more members. In , your out-of-pocket maximum can be no more than:.
Starting in , individual limits apply to everyone with coverage, even those who are part of a family plan. Those limits are high and would be difficult for most Americans to pay. These choices will be signaled globally to our partners and will not affect browsing data.
We and our partners process data to: Actively scan device characteristics for identification. I Accept Show Purposes. Your Money. Personal Finance. Your Practice. Popular Courses. Part Of. Know the Basics. Learn the Lingo. What Does Health Insurance Cost? Your Health Insurance Premium. Understanding Deductibles. Finding a Health Plan. Personal Finance Insurance. What Is an Out-of-Pocket Maximum? There is a range of out-of-pocket limits an individual or family may choose from, such as lower out-of-pocket maximums and higher premiums or higher out-of-pocket maximums and lower premiums.
Some individuals or families may qualify for lower out-of-pocket maximums through cost-sharing reduction discounts if they earn under certain income thresholds and meet other requirements.
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