What is an out-of-pocket minimum?

An out-of-pocket minimum is a minimum amount of money that a person must spend on health care costs before their health insurance kicks in. This amount is a set dollar amount or a certain percentage of the total health care cost. In California, health plans must have an out-of-pocket minimum of $4,900 for individuals or $9,800 for families. This means that individuals or families must pay the first $4,900 or $9,800 of their healthcare costs before their health insurance begins to cover the remaining costs. The out-of-pocket minimum is designed to help people manage the cost of their health care, as it helps to spread out the costs of care over a long period of time, rather than having to pay them all at once. Additionally, it helps to protect insurance companies from high upfront costs by having the insured pay a portion of the costs out of pocket.

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