Deductibles Versus Out-Of-Pocket Maximum

July 12th, 2012 by Navid J. Leave a reply »

The deductible is the amount that must be met before the insurance company starts to cover expenses.  For many routine visits like seeing a doctor, the deductible is waived.  Meaning, make sure you check and see when your deductible will apply.  The out-of-pocket maximum is the most you will have to pay per year.  Once you meet this maximum, the plan covers 100% of all bills for the rest of the year.  This number resets every January so be careful.  It is important before you decide which health insurance plan is right for you, that you know the difference between these two benefits.  Sometimes a very high deductible only makes sense if you are on the healthier side because it can be quite costly if you start to use medical services.  The maximum is basically your cap for the year.  So if a catastrophic event happens, the out-of-pocket maximum amount will be the most you will be charged.  Each January that figure will reset.


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