Out-of-Pocket Maximum

Also called: maximum out-of-pocket, MOOP

The out-of-pocket maximum is the most you have to pay for covered, in-network care in a plan year through deductibles, copays, and coinsurance combined. Once you reach it, the plan pays the full cost of covered services for the rest of the year. Premiums and non-covered services do not count toward this limit.

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Disclaimer: This definition is provided for general educational purposes only and is not legal, medical, or insurance advice. Insurance rules, deadlines, and terminology vary by plan, state, and over time. Always check your own plan documents and confirm current details before acting.