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An Annual Out-of-Pocket Maximum is a limit on how much you are required to pay within
your health plan's benefit year for certain covered services through applicable deductibles,
co-insurance, and co-payments. Your monthly premium is not included in your Annual Out-of-Pocket
Maximum. This means that once you've spent this amount, your health insurance carrier
will cover 100% of the costs of almost everything else you need medically. The maximum is in
place to protect you and your family from extremely high medical bills. Let's say the
health plan you selected has an Annual Out-of-Pocket Maximum of $5,000. If you spend $5,000 or
more on routine doctor visits and tests in a year, then have an accident, the hospitalization
will be fully covered by the health plan. Choosing a health plan with higher Annual
Out-of-Pocket Maximum means you are responsible for a greater portion of your medical bills,
but your monthly premiums may be lower. So be sure to select an Annual Out-of-Pocket
Maximum at a reasonable level for you and your family.