Out-of-pocket maximum
The most you'll pay for covered in-network care in a plan year — after that, insurance pays 100%.
Why it matters
Includes deductibles, copays, and coinsurance. The 2025 ACA maximum is $9,200 single, $18,400 family. Knowing your OOP max is essential for worst-case-year budgeting.
Educational only — not financial, tax, or legal advice.