A Deductible Is What You Pay Before Insurance Pays; the Out-of-Pocket Maximum Caps Your Yearly Costs
The Fact
HealthCare.gov defines a deductible as the amount you pay for covered health care services before your insurance plan starts to pay. The out-of-pocket maximum is the most you have to pay for covered services in a plan year; after you reach it, the plan pays 100% of covered services. Premiums do not count toward either one.
What This Means
Your monthly premium is just the price of having insurance. You still pay the deductible, copays, and coinsurance until you hit the out-of-pocket limit.
Why It Matters
Knowing these numbers is how you figure out what a bad year could really cost.
Sources
HealthCare.gov. Glossary: “Deductible.” https://www.healthcare.gov/glossary/deductible/
HealthCare.gov. Glossary: “Out-of-pocket maximum/limit.” https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/