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What Is an Out-of-Pocket Maximum and How Does it Help Me?

This is called the out-of-pocket maximum. The out-of-pocket maximum gives you peace of mind because you can be sure you won’t pay more than that amount during the year.

Having an out-of-pocket maximum is one of the advantages to an HMO plan. If you relied only on Original Medicare for your health coverage, there is no limit on the amount you may need to spend in a year.