The out-of-pocket limit is the maximum amount of money that an individual is obligated to pay for covered healthcare services within a specific period, typically a calendar year, under their health insurance plan. Once this limit is reached, the insurance plan generally covers 100% of eligible expenses for covered services, including deductibles, copayments, and coinsurance. Out-of-pocket limits provide financial protection to individuals by capping their out-of-pocket expenses and ensuring that they do not face excessive financial burdens due to medical costs. These limits vary depending on the insurance plan and may differ for in-network and out-of-network services.
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