Orlando Home Listings

Auto Insurance Quote

Boat Insurance Quote

Commercial Property Insurance Quote

Dental Insurance Quote

Directors & Officers Insurance Quote

Free Home Valuation Estimate

Disability Insurance Quote

E&O Insurance Quote

Flood Insurance Quote

Garage Insurance Quote

General Liability Insurance Quote

Real Estate Information

Group Insurance Quote

Health Insurance Quote

Homeowners Insurance Quote

Life Insurance Quote

Motorcycle Insurance Quote

About Michael Grace

Personal Watercraft Insurance Quote

Renters Insurance Quote

Surplus Lines Insurance Quote

Umbrella Insurance Quote

Workers Compensation Insurance Quote

Grace Financial Service Associates

Get Free Quotes Now!
Home Page - Grace Financial Service Associates         Call Us Today - (407)340-1010

What is an Out-of-Pocket Maximum?

What is a Deductible?

What is a Network Discount?

What is Coinsurance?

What is an Out-of-Pocket Maximum?

What is a Copay?

How Do I Lower My Premium?

Other Frequently Asked Questions

To understand what an "out-of-pocket maximum" is you must first understand what a deductible is, and also what coinsurance is. If you are not familiar with what a deductible is or what a coinsurance is, then please see "What is a Deductible?" first, followed by "What is Coinsurance?".

An "out-of-pocket maximum" is set level at which you are no longer responsible for your coinsurance responsibility. It is the same as a cap on your total medical bill expenses. For example, say you have a plan with a $1500 deductible and a 20% coinsurance, you are not only responsible for the $1500 out-of-pocket deductible, but you are responsible for 20% of the remaining bill as "out-of-pocket" costs. That said, if you have a medical bill of $50,000 after a complicated surgery, you will be responsible for your deductible of $1500, and also 20% of the remaining $48,500, or an additional $9700. However, if your plan has an "out-of-pocket maximum" of $7000, then you do not pay one penny more than $7000 despite your coinsurance responsibility. The most you would pay in any medical circumstance is $7000 if your "out-of-pocket maximum" is $7000. (Note: if you are on a 0% coinsurance plan, your out of pocket maximum is exactly the same amount as your deductible because the insurance company pays 100% of all medical bills after the deductible is met. In our example above, the "out-of-pocket maximum" would be $1500 on a 0% coinsurance plan.)

Want a plan with a lower "out-of pocket maximum"?

Get Free Quotes, compare rates, and view plans in seconds by filling in the form below.

Insurance Quotes - Grace Financial Service Associates Frequently Asked Questions - Grace Financial Service Associates Terms of Use - Grace Financial Service Associates Privacy Policy - Grace Financial Service Associates Contact Us - Grace Financial Service Associates Professional Business Partners - Grace Financial Service Associates