What is an out-of-pocket maximum?

An out-of-pocket maximum is a limit on how much an individual has to pay towards their health care costs. In Washington, it is the highest amount of money an individual is responsible for within a given year on their medical costs. This amount is reached through deductibles, co-pays, and co-insurance. The amount varies depending on the health plan and the type of services received. The out-of-pocket maximum is intended to protect consumers from having to pay for excessively expensive medical bills. After an individual has reached their out-of-pocket maximum, their insurance plan will cover the remainder of the medical expenses for the remainder of the year, and will help them save money on necessary health care. The out-of-pocket maximum is not the same as the annual deductible, although the two are sometimes confused with each other. The deductible is the amount that the consumer must pay before their insurance plan covers any of their medical expenses. The out-of-pocket maximum is the maximum amount that the consumer is responsible for in a given year before their insurance plan takes over and covers the rest. It is important to know and understand this law in Washington, as it can help protect consumers from having to pay for expensive medical bills. Understanding the out-of-pocket maximum can help one make informed decisions when it comes to choosing a health plan and taking care of their health.

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