Out-of-pocket maximum

The out-of-pocket maximum is the cap placed on the amount of money you pay from your own cash reserves for deductibles, copayments, and coinsurance. In 2022, the out-of-pocket maximum for an individual is $8,700 and $17,400 for a family. 

It typically only applies to in-network care and health services covered by your health plan. If you seek out-of-network care, you may find the out-of-pocket maximum is higher or it may even be uncapped. 

Related Terms:

Coinsurance

Copayment / copays

Deductibles

In-network

Out-of-network

Out-of-pocket expenses

 

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