Maximum out of pocket Question!!...

Plusizeteen · May 1, 2006

I have a Maximum out of pocket of 1,000.00 not including the deductible. Does that mean if I where to get the band the most I would have to pay was 1,000.00 + deductible??

Plusizeteen · May 1, 2006

PS. In my insurance handbook it says (Single out of Pocket) is 1,000.00 BUT (Family out of Pocket) means that all 3 family members must meet the single out of pocket. Anyone have a clue what this means?

Alexandra · May 1, 2006

Yes, you are correct in that your max-out-of-pocket (MOOP) is your deductible plus $1000. That's in a calendar year, so it resets at the end of the year. All money you spend related to your medical care as a patient go toward your MOOP.

The family MOOP is just another cap. If three people in the family meet their individual MOOPS in a calendar year, the whole family will be considered to have met it and there will be no more out-of-pocket expenses for anyone in the family, even if the family has more than 3 people.