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Out-of-Pocket Maximum

The most you'll have to pay for covered health care services in a plan year. After you reach your out-of-pocket maximum, your insurance company will typically pay 100% of the allowed amount for covered services.

Detailed Explanation

This limit helps protect you from very high medical costs in a given year.

Practical Example

Lisa's health insurance plan has an out-of-pocket maximum of $6,000. If her medical expenses for the year reach this amount, her insurance company will pay for all further covered services for the rest of the year.

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