What is an Out-of-Pocket Maximum?

The out-of-pocket maximum is the highest dollar amount you will need to pay during your benefit period (calendar year) for covered medical services from network providers. Once you reach the out-of-pocket maximum, your health plan reimburses your network caregivers for any remaining covered services during your benefit period. Depending on your plan, using out-of-network providers may affect an out-of-pocket maximum and increase the amount you pay. Non-covered services and amounts over the maximum allowable charge do not apply to an out-of-pocket maximum.