Affordable Care Act
Out-of-pocket costs are costs for health care that aren’t reimbursed by insurance companies. Generally, out-of-pocket costs include copays, deductibles, and coinsurance for covered services, as well as expenses for services that aren’t covered by insurance companies.
It’s also important for you to know that there is an annual limitation on all cost-sharing for which patients are responsible under a health insurance plan. This out-of-pocket limit (or out-of-pocket maximum) does not apply to premiums, balance-billed charges from out-of-network health-care providers, or services that are not covered by the plan.
A Marketplace plan in 2017 had an out-of-pocket-limit of $7,150 for individuals, and $14,300 for a family plan.