The Max Out of Pocket Benefit

Open enrollment is now over for the 2018 year. If you recently purchased a health insurance Nevada policy, you may be wondering what the max out of pocket benefit is and why it is the most important number on the page. There are many other benefits that consumers might focus on more such as doctor visits or prescription copays. While these are important to the plan, it is not the reason why a policy is an actual insurance plan.

There many other policies that provide reimbursement for doctor visits or other medical services. While the price for these plans can be inexpensive, they will not provide you with financial protection in the event of a catastrophic situation. Therefore, you may be paying for all the costs that might come with a serious accident or illness. High medical expenses are the number one cause of personal bankruptcy in the United States. Purchasing a qualified plan can move that risk away from you.

How it Works

On every real insurance plan, you should see the max out of pocket benefit amount before you purchase the policy. For a Reno health insurance policy, the most that amount can be $7,900 for an individual. This means that if you have medical expenses that you have paid for throughout the year that are higher than that amount, you will be covered for 100% for the remainder of the year. This is true even for expenses that happen later in the year that are completely unrelated to the original event. Hopefully, you will never have a situation where you will be using the max out of pocket benefit but it is the reason why the plan is considered insurance. In exchange for the monthly premium, you move the risk of being unable to pay high medical bills off of you and to the insurance company.

If you have any questions about your policy benefits or if you would like to enroll, please call our office. As your health insurance broker, we do not charge you any fees to use our services. You would also pay the same amount for the plan if you went directly to the insurance company.