Sun, 02/09/2020 - 16:40

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.

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Out-of-Pocket Maximum

• When does my plan pay 100%?