Out-of-pocket Maximum (OOPM)


Posted by: Altura Benefits in

The most you have to pay for covered services in a plan year. After you spend this amount on the combined total of deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.

The out-of-pocket limit doesn’t include your monthly premiums. It also doesn’t include anything you spend on services your plan doesn’t cover.