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The out-of-pocket maximum caps your total spending on covered, in-network care in a plan year, including deductibles, copays, and coinsurance. Once you hit it, the insurer pays 100% of covered costs for the rest of the year. It is the figure that defines your worst-case medical exposure.
After reaching a $7,000 out-of-pocket maximum, covered care costs you nothing more that year.
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