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 2015, the out-of-pocket limits are $6,600 for an individual plan, and $13,200 for a family plan for the year. That’s the most you would pay for the year. After you reach that limit, your health plan pays 100 percent of the services it covers. What counts toward your out-of-pocket limits? It probably doesn’t include your premiums. But it can include costs like deductibles, coinsurance, copays, and sometimes what you pay for care that’s out of your plan’s network.

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Last Updated On

April 27, 2018

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