What Is Out-of-Pocket Maximum?
The most the insured will have to pay for covered expenses in a policy period; once reached, the insurer pays 100% of remaining covered costs.
Out-of-Pocket Maximum across 2 exams
Out-of-Pocket Maximum appears on the following exams. Each defines it in the context candidates are tested on:
- Health Insurance
- The most the insured will have to pay for covered expenses in a policy period; once reached, the insurer pays 100% of remaining covered costs.
- Health-Only Insurance
- The total dollar amount the insured must pay in deductibles, copayments, and coinsurance before the insurer pays for covered services at 100 percent. Once reached, the insurance company pays all remaining eligible expenses for that plan year.