Generally it's out of pocket maximum to a point, like $250k. Then it's normally split, something like 80-20, where you have to cover 20% of the bill. That seems like a lot until you have something like cancer, where you need surgery plus chemo in the same year, which adds up quite fast.
> Generally it's out of pocket maximum to a point, like $250k. Then it's normally split, something like 80-20, where you have to cover 20% of the bill.
Not since the Affordable Care Act of 2010. It got rid of benefit maximums and implemented out of pocket maximum. An out of pocket maximum up to a limit is a contradiction. The situation works exactly opposite, you first pay 100% up to deductible, then you pay a proportion according to your copay, then you pay 0% after the out of pocket maximum.
Annual out of pocket maximums are typically $5k to $10k for individual/family at any half decent employer.
