06/09/2026
The out-of-pocket maximum is the most you’ll have to pay for covered healthcare services in a policy year before your insurance pays 100% of the costs. It includes deductibles, copayments, and coinsurance, and out-of-network copays (NOT self-pay/ out-of-pocket), and Not Premiums or Prescription Drug costs. Most Medicare Advantage plans vary the Max amounts between their In-Network and Out-of Network Maxiumum Out of Pocket costs.