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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My wife had significant medical expenses across two different years. She had to have emergency brain surgery and spend several days in the neuro ICU, and then later in the year and into the next year had to undergo cancer treatment (unrelated to the brain surgery, just really bad timing). Across the two years that these things happened, we racked up well over 2 million dollars in medical bills between hospital stays, the surgeries, and then the 50ish rounds of radiation. We luckily had very good insurance (worked at a state university), and she only had to cover about 3k of total charges across the two years. She hit her out of pocket max in the second year after one round of radiation treatment, and her care for the rest of the year was essentially covered for free.
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