What is the different between deductible and Out of pocket?

Question

So, I am looking for a new health insurance and I am seeing alot of deductible and Out of pocket but idk how they are different. Like, I understand that prescription and visits go to your deductible but what go to your Out of pocket

In: Other

Answer 1

In health insurance, you have a deductible and an OUT OF POCKET MAXIMUM.

Under covered services, you have a deductible. This is an amount of money you must pay before insurance covers anything for that care.

After the deductible is paid, insurance will usually pay 70%+ for all of the care depending on co-pay/co-insurance. You would pay the rest.

This holds true UNTIL you reach an OUT OF POCKET MAXIMUM. At this point, you have paid all you can and the insurance company will cover 100% for the covered service.

An example plan would be a 1000 deductible with a 10000 out of pocket maximum.

You pay 1000 before insurance covers anything, then you share expenses (usually something like 70/30 to 90/10 split) until you get to 10000 dollars, your max. From there, insurance covers everything.