Out-of-Pocket Maximum
Annual cap on total cost-sharing required of an insured under a health plan.
FAQs
What is the difference between the out-of-pocket maximum and the deductible?
The deductible is the amount you must pay before the insurance company starts sharing costs—once met, you enter cost-sharing (copays, coinsurance). The out-of-pocket maximum is the total cap on all cost-sharing for the year—once reached, the insurer pays 100%. The deductible is always less than or equal to the OOPM; it's the first threshold, while the OOPM is the final ceiling. Between the deductible and OOPM, you pay coinsurance or copays. Example: $2,000 deductible, $6,500 OOPM, 20% coinsurance: pay full costs first $2,000, then 20% of costs until total out-of-pocket reaches $6,500, then insurer covers 100%.
Do out-of-network costs count toward the out-of-pocket maximum?
For most ACA-compliant plans, out-of-network costs do not count toward the in-network out-of-pocket maximum—the insurer maintains separate deductibles and OOPMs for in-network and out-of-network services. Costs from out-of-network providers (balance billing, non-covered portions) may not count at all. However, emergency services (required to be covered at in-network rates under the No Surprises Act) and services at in-network facilities where only out-of-network providers were available are subject to in-network cost-sharing rules—these costs count toward the in-network OOPM. HMOs and EPOs may provide no out-of-network coverage at all (except emergencies), making the distinction moot for most services.
Can a family member's costs count toward both individual and family out-of-pocket maximums?
Yes—in plans with embedded individual OOPMs, each family member's costs count simultaneously toward both their individual OOPM and the family aggregate OOPM. Once any individual reaches their embedded individual limit ($9,450 in 2024 for many plans), the insurer pays 100% for that individual's remaining covered costs—even if the family's aggregate OOPM hasn't been reached. The remaining family members continue accruing costs toward the family aggregate OOPM. This embedded structure particularly benefits families where one member has very high costs—that member reaches their individual OOPM early while other members continue cost-sharing under the family aggregate.
Related Terms
Deductible
Amount the insured must pay out-of-pocket per claim before insurance coverage begins.
Copayment
Fixed amount the insured pays for a covered health care service at the time of service.
Coinsurance
Percentage of costs the insured shares with the insurer after the deductible is met.
Premium
Regular payment made by a policyholder to maintain insurance coverage.