What Are the Limits on Out-of-Pocket Costs?

The health care law puts a limit on what you pay each year out of your own pocket for the medical expenses covered by your insurance, called “out-of-pocket limits.” 

For 2014, the out-of-pocket limits are $6,350 for an individual plan, and $12,700 for a family plan for the year. That’s the most you would pay for the year, and after you reach that limit, your health plan pays for 100 percent of the services it covers. What counts toward your out-of-pocket limits? It doesn’t include your premiums. But depending on your health plan, it can include costs like deductibles, co-insurance, co-pays, and sometimes care that’s out of your plan’s network.

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