OOPM stands for Out-of-Pocket Maximum. Some insurance plans may also refer to the term as Out-of-Pocket Limit.
♦ The most you have to pay for covered services in a plan year.
After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered healthcare services.
The Affordable Care Act controls the maximum out-of-pocket that insurance companies can ask for in-network services.
• When does my plan pay 100%?