How does out of pocket max work?

Question

We already have payed 2000 and our out of pocket max is 6000 so if I go to the hospital and have a very high bill will I only have to pay 4000? And they will cover the rest 100%? Asking because I’m having a unplanned high risk pregnancy ☹️

Answer

After you meet your deductible your plan covers a certain percent of all charges until you meet your out of pocket maximum. Once you have paid the out of pocket max, everything after that is covered at 100% until your benefit year starts over. Your deductible may or may not apply towards your out of pocket, you would need to either check your plan documents or call your insurance company to look at your specific plan.

Answer

Yes the most you can pay is the 6,000 until your plan starts over.

Answer

Correct, as long as its all in one year

How does out of pocket max work?

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