Out Of Pocket Maximum In Health Insurance

LAS VEGAS - Nov. 3, 2023 - PRLog -- Each plan can have a lower out-of-pocket maximum, these numbers are the worst-case scenario. Check your plans "Summary of Benefits" for details.

Your out-of-pocket maximum is the most you'll have to pay for covered services in a policy period (one year), each January 1st it starts over again, and that includes cost of medications too. After you reach this amount, your health insurance plan will pay 100% for covered benefits called "essential healthcare benefits". Your out-of-pocket costs are NOT your health insurance premiums. Your monthly premiums are totally separate and are in addition to your medical costs like co-pays, deductibles, and out of pocket maximums.

Think of it like a game of baseball. Once you've paid all of your "deductible", you are standing on 1st base. Now you'll begin to move towards 2nd base – "Co-Insurance".  During this time, co-insurance is where you and the insurance company split the medical bills (co-insure), for example 70/30 or 80/20.  Usually, the insurance company will pay the larger amount and you'll pay the lesser amount.

Your next step is 3rd base or your "Out of Pocket Maximum". Once you've met your "out of pocket maximum", you are now done paying anything else. The insurance company will pick you up on 3rd base, and carry you to home plate (they are responsible for unlimited coverage after your out of pocket maximum).

Note:  This is an annual accrual, meaning it starts January 1st and ends December 31st each year.

Read the full article: https://www.nevadainsuranceenrollment.com/health-insuranc...

Learn more: https://www.nevadainsuranceenrollment.com/individual-fami...

Nevada Insurance Enrollment
4260 W. Craig Road suite #150-A
North Las Vegas, NV 89032
(702) 898-0554
Website: NevadaInsuranceEnrollment.com