What is an annual maximum?

An annual maximum is the total amount of money that an insurance plan will cover for each person for any particular year. In Washington, annual maximums are regulated by health insurance law. These limits vary by insurer and plan type and typically range from $10,000 to $1 million or more. The annual maximum is the total amount of money that will be paid out for all medical expenses, including hospital visits, surgeries, prescriptions, and visits to doctors. This limit means that if the cost of healthcare for an individual exceeds the annual maximum, the person will have to pay the difference out-of-pocket. It is important for people to be aware of their plan’s annual maximum and to do their best to stay within it so that they do not incur additional costs. Purchasing supplemental insurance is an option for those who anticipate medical expenses that will exceed the plans annual maximum.

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