This may sound silly but what does "$1000 max out of pocket" mean insurance wise?

Question

Does it mean that after 1000 we arent liable or it gets wrote off? I am going through a high risk pregnancy and even at 28 weeks today I have met 580 of my max out of pocket. Does this "out of pocket" include my 250 deductible? Any help or ideas thanks!

Answer 1

ur goin to pay alot for insurance

Answer 2

Yes, it includes the $250.  The $1000 is the maximum that you have to personally pay for things that are covered by the insurance.  After you have paid the $250 deductible and $750 in copays, the insurance pays the entire amount of the remaining bills for the year (no more copays until the next year).

Answer 3

It means that once you have paid $1000 everything else will be covered by the insurance company at 100% so the most you can pay from your own money is $1000.

Answer 4

Yes, It means that the most your will have to pay is $1000 for year. Typically, your deductible is included. Since, you are like 7 months into your pregnancy your deductible and out of pocket costs may be counted in for last years. ( depending on when your plan year starts) Many plan years start over in January. Which means that another deductible and out of pocket count starts over again. You may want to talk to whoever handles your benefits at work.

I hope this was helpful and CONGRATZ !