The most you must pay under your health insurance agreement for covered services during a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health insurance begins to pay 100% of the costs for covered services.
Out-of-pocket costs do not include your premium, amounts spent on services not covered by your plan, out-of-network care and services, and costs above the allowed amount for a service a provider may charge.
Your Out-of-Pocket Limit may change annually and varies by plan type.