Out-of-Pocket Maximum

out-of-pocket maximumMembers are protected by the out-of-pocket maximum, which places a limit on the amount you pay for deductibles, coinsurance and co-payments in a calendar year before your health plan covers the full cost of Medicare covered expenses. The out-of-pocket maximum for the 2017 plan year for a Marketplace plan is $7,150 for an individual plan and $14,300 for a family plan.

Martin was relieved when he reached his out-of-pocket maximum, because he still needed prescription drugs and was glad that his plan would cover the cost.