What does the term "out-of-pocket maximum" signify in a health insurance plan?

Study for the ABC – Health Access Exam. Simulate real test conditions with multiple choice questions and explanations. Enhance your preparation and get exam-ready!

The term "out-of-pocket maximum" refers specifically to the highest amount a policyholder will have to pay for covered services within a given plan year. This means that once a policyholder has paid this amount in deductibles, copayments, and coinsurance for covered medical services, the health insurance plan will then cover 100% of the costs for any additional covered services for the remainder of that year. This limit provides financial protection against excessive medical expenses and ensures that there is a cap on the out-of-pocket costs that the policyholder is responsible for, promoting accessibility to necessary healthcare services without the risk of financial strain due to high medical bills.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy