What is an out-of-pocket maximum for medical insurance?

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If an out-of-pocket maximum is $3,500, and you get a hospital bill for $10,000, do you only have to pay the $3,500, or the full $10k?

After you meet the deductible and out-of-pocket max, is care essentially “free” the rest of the year since you don’t have to pay out of pocket?

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13 Answers

Anonymous 0 Comments

Basically yes, if you meet your deductible, anything else that is covered is free. For example, last year I had surgery on January 10, and that definitely met my deductible, so all other appointments and prescriptions for me and my spouse for the rest of the year were free.

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