Out-of-pocket maximum.
The annual cap on what you pay.
The most you'll pay for covered medical services in a plan year. Includes deductible, coinsurance, and copays for in-network care. Once you hit it, your insurer pays 100% of covered services for the rest of the year. ACA requires every plan to have one.
Use this in real life.
The price comparison tool surfaces every term in this glossary in context — plan tiers, deductible status, cash-pay vs. negotiated rate. Pick a procedure to see them all in action.
Browse procedures →