Out-of-pocket costs, sometimes called OOP
There are often out-of-pocket costs you must pay when you use health care services, such as a visit to the doctor or medication. Here are some fees that add up to your total out-of-pocket costs:
- Out-of-network payments
There are limits on how much of these costs you have to pay. Once you hit this limit, called the out-of-pocket maximum, your plan will pay 100% for covered benefits.
The out-of-pocket maximum will vary each year. With the exception of grandfathered policies, all health plans, including those offering only catastrophic coverage, must limit out-of-pocket spending to $6,850 for an individual and $13,700 for a family in 2016.