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

Question

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?

In: Other

Answer 1

Your understanding is correct: once you reach the $3500 out of pocket maximum (in costs you’re responsible for, not total billed charges), any covered services will be paid out 100% by your insurer.