{"id":428,"date":"2026-10-15T15:18:56","date_gmt":"2026-10-15T15:18:56","guid":{"rendered":"https:\/\/www.coveragefox.com\/knowledge-center\/?p=428"},"modified":"2026-10-15T22:02:02","modified_gmt":"2026-10-15T22:02:02","slug":"out-of-pocket-maximum-vs-deductible","status":"publish","type":"post","link":"https:\/\/www.coveragefox.com\/knowledge-center\/out-of-pocket-maximum-vs-deductible\/","title":{"rendered":"Out-of-Pocket Maximum vs. Deductible: What\u2019s the Difference?"},"content":{"rendered":"\n<div class=\"c-section c-section--not-top-padding  \" >\n    <div class=\"o-wrapper o-wrapper--small\">\n        <div class=\"c-section__content\">\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_1e55f4048fe96ac6b8b9e9dd3d80a342\">\n                                      <p>A deductible and an out-of-pocket maximum both affect what you pay for health care, but they work differently.<\/p>\n<p>Your deductible is the amount you pay for certain covered services before your health plan begins sharing those costs. Your out-of-pocket maximum is the most you\u2019ll pay in eligible cost sharing for covered in-network services during a plan year.<\/p>\n<p>Knowing the difference can help you <a href=\"https:\/\/www.coveragefox.com\/plan-comparison-overview\/\">compare health insurance plans<\/a> and understand your potential costs.<\/p>\n<h2><strong>Key Takeaways<\/strong><\/h2>\n                   <\/div>\n\n\n\n<ul class=\"c-list-check\">\n                        <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>A deductible is the amount you pay for certain covered services before your health plan begins sharing those costs.<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>An out-of-pocket maximum limits what you pay in eligible cost sharing for covered in-network services during a plan year.<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Eligible deductibles, copayments, and coinsurance generally count toward a Marketplace plan\u2019s out-of-pocket maximum. Premiums don\u2019t.<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Meeting your deductible doesn\u2019t mean all covered care becomes free. You may continue paying copayments or coinsurance.<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>After reaching your out-of-pocket maximum, your plan generally pays 100% of covered in-network benefits for the rest of the plan year.<\/p>\n            <\/div>\n        <\/li>\n\n        \n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_8a2e3282c829fcedaa91984bc215529a\">\n                            <h2 >Deductible vs. Out-of-Pocket Maximum: The Main Difference<\/h2>                               <\/div>\n\n\n\n<div class=\"o-component c-simple-table js-simple-table js-expandable-content\" id=\"acf-general-simple-table-block_993548539c4da2c988e667238611ac6e\">\n    <div class=\"c-simple-table__indicator js-simple-table-indicator\">\n        Scroll for more \n        <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/themes\/coveragefox\/assets\/images\/components\/simple-table\/icon-scroll.svg\" alt=\"\" aria-hidden=\"true\" width=\"30\" height=\"30\">\n    <\/div>\n    <div class=\"c-simple-table__content\">\n    <table class=\"c-simple-table__table\"><thead><tr><th><\/th><th>Deductible<\/th><th>Out-of-Pocket Maximum<\/th><\/tr><\/thead><tbody><tr><td><strong>What is it?<\/strong><\/td><td>What you generally pay for certain covered services before your plan starts sharing costs<\/td><td>The limit on eligible cost sharing for covered in-network services during a plan year<\/td><\/tr><tr><td><strong>What happens when you reach it?<\/strong><\/td><td>Your plan generally begins sharing eligible costs<\/td><td>Your plan pays 100% of covered in-network benefits for the rest of the plan year<\/td><\/tr><tr><td><strong>Do premiums count?<\/strong><\/td><td>No<\/td><td>No<\/td><\/tr><tr><td><strong>Can copays and coinsurance count?<\/strong><\/td><td>Depends on the plan<\/td><td>Generally, yes, for covered in-network services<\/td><\/tr><tr><td><strong>Do you keep paying after reaching it?<\/strong><\/td><td>Usually, through copays or coinsurance<\/td><td>Generally, not for covered in-network benefits<\/td><\/tr><\/tbody><\/table>    <\/div>\n    <\/div>\n<div class=\"o-component s-cms-content\">\n    <p>Check your Summary of Benefits and Coverage and other plan documents for details specific to your coverage.<\/p>\n<\/div>\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_9c92a92c14e79c9e3c2fd7ea28a371ca\">\n                            <h2 >What Is a Health Insurance Deductible?<\/h2>                                      <p>A health insurance deductible is the amount you pay for certain covered services before your plan begins paying its share.<\/p>\n<p>For example, with a $2,000 deductible, you may need to pay the plan\u2019s negotiated cost for certain services until eligible spending reaches $2,000. After that, your plan may begin sharing costs through copayments or coinsurance.<\/p>\n<p>Some services may be covered before you meet the deductible. Plans can also have separate deductibles for certain services or prescription drugs, while family coverage may include individual and family deductibles.<\/p>\n<p>Understanding <a href=\"https:\/\/www.coveragefox.com\/knowledge-center\/how-health-coverage-premiums-and-deductibles-work-together\/\">how premiums and deductibles work together<\/a> can help you evaluate a plan\u2019s potential total cost.<\/p>\n                   <\/div>\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_42a739e11fa63c3c7b848f73ac4d5cc9\">\n                            <h2 >What Is an Out-of-Pocket Maximum?<\/h2>                                      <p>An out-of-pocket maximum, or out-of-pocket limit, is the most you\u2019ll pay in eligible cost sharing for covered in-network services during a plan year.<\/p>\n<p>Eligible expenses can include:<\/p>\n                   <\/div>\n\n\n\n<ul class=\"c-list-check\">\n                        <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Deductible payments<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Copayments<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Coinsurance<\/p>\n            <\/div>\n        <\/li>\n\n        \n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_bc308be1adc3d956cfd149e72520ffa1\">\n                                      <p>Once you reach the limit, your plan pays 100% of covered in-network benefits for the rest of the plan year. You still pay your monthly premium, and some expenses, such as non-covered services and certain out-of-network costs, generally don\u2019t count.<\/p>\n<p>Coverage Fox\u2019s <a href=\"https:\/\/www.coveragefox.com\/glossary\/\">health insurance glossary<\/a> can help explain other common insurance terms.<\/p>\n                   <\/div>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"720\" height=\"320\" src=\"https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2026\/10\/Out\u2011of\u2011Pocket-Maximum-vs.-Deductible-2.png\" alt=\"Patient discussing health insurance and medical care options with a healthcare provider.\" class=\"wp-image-430\" srcset=\"https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2026\/10\/Out\u2011of\u2011Pocket-Maximum-vs.-Deductible-2.png 720w, https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2026\/10\/Out\u2011of\u2011Pocket-Maximum-vs.-Deductible-2-300x133.png 300w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\" \/><\/figure>\n<\/div>\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_bde1210bf606eeff05018245eeaa6ba4\">\n                            <h2 >What Counts Toward Your Deductible?<\/h2>                                      <p>What counts depends on the plan. Costs for covered services subject to the deductible may include:<\/p>\n                   <\/div>\n\n\n\n<ul class=\"c-list-check\">\n                        <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Lab work<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Imaging<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Hospital care<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Specialist services<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Prescription drugs<\/p>\n            <\/div>\n        <\/li>\n\n        \n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_5b4b1c75b3342f4c2e11f265b377c18d\">\n                                      <p>Not every covered service is necessarily subject to the deductible. Some plans cover certain services with a copayment before you meet it. Preventive services covered under applicable Affordable Care Act (ACA) requirements may also be available in-network without cost sharing.<\/p>\n<p>Check your plan documents to see which services apply to your deductible.<\/p>\n                   <\/div>\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_9f1f4b27b65c4844c57ba069f9d2ea9b\">\n                            <h2 >What Counts Toward Your Out-of-Pocket Maximum?<\/h2>                                      <p>For Marketplace plans, eligible deductibles, copayments, and coinsurance for covered in-network services generally count toward the out-of-pocket maximum.<\/p>\n<p>Expenses that generally don\u2019t count include:<\/p>\n                   <\/div>\n\n\n\n<ul class=\"c-list-check\">\n                        <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Monthly premiums<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Services the plan doesn\u2019t cover<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Certain out-of-network care<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Amounts above the plan\u2019s allowed amount in situations where those charges are permitted<\/p>\n            <\/div>\n        <\/li>\n\n        \n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_36a3eec0554d1782cc000fe635747285\">\n                                      <p>Plan rules vary, so review your policy for details.<\/p>\n                   <\/div>\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_ec97ecc8222e73538715659045275e7d\">\n                            <h2 >How a Deductible and Out-of-Pocket Maximum Work Together<\/h2>                                      <p>Eligible amounts paid toward your deductible can also count toward your out-of-pocket maximum.<\/p>\n<p>Consider a hypothetical plan with:<\/p>\n                   <\/div>\n\n\n\n<ul class=\"c-list-check\">\n                        <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>A $2,000 deductible<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>20% coinsurance after the deductible<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>A $9,000 out-of-pocket maximum<\/p>\n            <\/div>\n        <\/li>\n\n        \n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_71ddca1b010c547c26a9fff32779dc5d\">\n                                      <h3><strong>Step 1: Meet the Deductible<\/strong><\/h3>\n<p>You receive $2,000 in covered in-network care subject to the deductible and pay $2,000.<\/p>\n<p>You\u2019ve now met your deductible, and your eligible out-of-pocket spending is $2,000.<\/p>\n<h3><strong>Step 2: Start Coinsurance<\/strong><\/h3>\n<p>Next, you receive a covered in-network service with an allowed cost of $5,000.<\/p>\n<p>With 20% coinsurance, you pay $1,000. Your eligible out-of-pocket total is now $3,000:<\/p>\n<p><strong>$2,000 deductible + $1,000 coinsurance = $3,000<\/strong><\/p>\n<h3><strong>Step 3: Continue Sharing Costs<\/strong><\/h3>\n<p>As you receive additional covered in-network care, eligible copayments and coinsurance continue adding to your out-of-pocket total.<\/p>\n<h3><strong>Step 4: Reach the Out-of-Pocket Maximum<\/strong><\/h3>\n<p>Once eligible spending reaches $9,000, your plan pays 100% of covered in-network benefits for the rest of the plan year.<\/p>\n<p>You still pay your premium and any expenses that aren\u2019t covered by the plan.<\/p>\n<p>The basic progression is:<\/p>\n<p><strong>Pay toward the deductible \u2192 Share eligible costs \u2192 Reach the out-of-pocket maximum \u2192 Plan pays 100% of covered in-network benefits for the rest of the plan year<\/strong><\/p>\n                   <\/div>\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_f0adeffc709d72ff7d142744624983d5\">\n                            <h2 >Individual vs. Family Deductibles and Out-of-Pocket Maximums<\/h2>                                      <p>Family health insurance may include both individual and family deductibles and out-of-pocket limits. One family member may reach an individual threshold before the household reaches the family threshold.<\/p>\n<p>When comparing family plans, look at:<\/p>\n                   <\/div>\n\n\n\n<ul class=\"c-list-check\">\n                        <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Individual and family deductibles<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Individual and family out-of-pocket maximums<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Copayments and coinsurance<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Prescription drug cost sharing<\/p>\n            <\/div>\n        <\/li>\n\n        \n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_34069c48d0e3e0a5de08714a7253969c\">\n                                      <p>How these amounts accumulate depends on the plan.<\/p>\n                   <\/div>\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_686f0524872ac093ebc68314608f3cb4\">\n                            <h2 >How Premiums Fit Into Your Health Insurance Costs<\/h2>                                      <p>Your premium is what you pay to keep your coverage active. It\u2019s separate from your deductible and out-of-pocket maximum and doesn\u2019t count toward either threshold.<\/p>\n<p>That\u2019s why the monthly premium shouldn\u2019t be the only number you compare. A lower-premium plan may have different deductibles, copayments, coinsurance, or out-of-pocket limits.<\/p>\n<p>When comparing <a href=\"https:\/\/www.coveragefox.com\/health-insurance-plans\/\">health insurance plans<\/a>, consider both the cost of maintaining coverage and what you could pay when receiving care.<\/p>\n                   <\/div>\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_bd2c0c2c4ad1f34e8d0a9ef69900e0dc\">\n                            <h2 >How to Compare Deductibles and Out-of-Pocket Maximums<\/h2>                                      <p>The right balance depends on your health care needs, household, budget, and available plans.<\/p>\n<p>Consider:<\/p>\n                   <\/div>\n\n\n\n<ul class=\"c-list-check\">\n                        <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Monthly premiums<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Deductible<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Out-of-pocket maximum<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Copayments and coinsurance<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Prescription drug coverage<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Provider network<\/p>\n            <\/div>\n        <\/li>\n\n                    <li class=\"c-list-check__item\">\n            <div class=\"s-cms-content\">\n            <p>Health care services you expect to use<\/p>\n            <\/div>\n        <\/li>\n\n        \n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_5ad748722826227e7ae9b4f712c8b51b\">\n                                      <p>If you\u2019re comparing different coverage options, understanding <a href=\"https:\/\/www.coveragefox.com\/knowledge-center\/aca-vs-private-health-insurance-whats-the-difference\/\">ACA vs. private health insurance<\/a> can help you evaluate your choices.<\/p>\n                   <\/div>\n\n\n        <div class=\"o-component s-cms-content \" id=\"acf-cms-content-block_ab89390327acb7fe311d529451082870\">\n                            <h2 >Can Financial Assistance Lower Health Insurance Costs?<\/h2>                                      <p>Depending on eligibility, financial assistance may lower Marketplace health insurance costs.<\/p>\n<p>Premium tax credits can reduce eligible consumers\u2019 monthly premiums. Some people who qualify for additional savings and enroll in an eligible Silver plan may also receive cost-sharing reductions that lower deductibles, copayments, coinsurance, and out-of-pocket maximums.<\/p>\n<p>Coverage Fox can help you determine whether you may <a href=\"https:\/\/www.coveragefox.com\/subsidy-savings\/do-i-qualify-for-healthcare-subsidy\/\">qualify for health insurance subsidies<\/a> and compare available plans.<\/p>\n                   <\/div>\n\n\n\n        <div class=\"c-cta-widget\">\n            <div class=\"c-cta-widget__content\">\n                                    <h2 class=\"c-cta-widget__title\">Compare Health Insurance Costs with Coverage Fox<\/h2>\n                                                    <div class=\"s-cms-content\">\n                        <p>Understanding your deductible and out-of-pocket maximum can help you compare plans and prepare for potential health care costs.<\/p>\n<p>Coverage Fox can help you compare <a href=\"https:\/\/www.coveragefox.com\/health-insurance-plans\/\">health insurance plans<\/a> based on premiums, deductibles, out-of-pocket maximums, benefits, and other plan details.<\/p>\n<p>Ready to explore your options? Give us a call at <a href=\"tel:888-676-4710\">888-676-4710<\/a>, <a href=\"https:\/\/www.coveragefox.com\/health-insurance-plans-by-state\/\">find health insurance options in your state<\/a>, or <a href=\"https:\/\/www.coveragefox.com\/plan-comparison-overview\/\">compare health insurance plans online<\/a>.<\/p>\n                    <\/div>\n                                <div class=\"c-form-field c-form-field__wrapper\" id=\"cta-widget\"><\/div>\n            <\/div>\n            <picture class=\"c-cta-widget__pic\">\n              <source media=\"(min-width: 43.75em)\" \n              srcset=\"https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2026\/01\/Ima-family-lg.webp, \n              https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2026\/01\/Ima-family-lg_2x-746x688.webp 2x\">\n              <img decoding=\"async\" class=\"c-cta-widget__img\" \n              src=\"https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/themes\/coveragefox\/assets\/images\/components\/hero\/ima-main-banner-lg.webp\" \n              srcset=\"https:\/\/www.coveragefox.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2026\/01\/Ima-family-lg.webp 2x\" \n              alt=\"\" loading=\"lazy\" width=\"280\" height=\"266\">\n            <\/picture>\n        <\/div>\n        \n\n                        <\/div>\n            <\/div>\n<\/div>\n\n\n\n    <div class=\"c-section c-section--bg-white c-section--not-top-padding\" id=\"acf-general-faqs-block_17aa5a72d0d97242d462936df3cfdacb\">\n        <div class=\" o-wrapper o-wrapper--small c-section__content\">\n        <div class=\"c-section-header\">\n            <div class=\"c-section-header__content\">\n                <h2 class=\"c-section-header__title c-section-header__title--medium c-section-header__title--centered\">Frequently Asked Questions About Deductibles and Out-of-Pocket Maximums<\/h2>\n            <\/div>\n        <\/div>\n        <div class=\"c-faqs\">\n                                                <details class=\"c-faqs__details\" open>\n                        <summary class=\"c-faqs__summary\">\n                            <h3 class=\"c-faqs__question\">Is a Deductible Included in the Out-of-Pocket Maximum?<\/h3>\n                        <\/summary>\n                        <div class=\"c-faqs__answer\">\n                            <div class=\"s-cms-content\">\n                                <p>For Marketplace plans, eligible amounts paid toward the deductible for covered in-network services generally count toward the out-of-pocket maximum.<\/p>\n                            <\/div>\n                        <\/div>\n                    <\/details>\n                                        <details class=\"c-faqs__details\" >\n                        <summary class=\"c-faqs__summary\">\n                            <h3 class=\"c-faqs__question\">Do Copays Count Toward the Deductible?<\/h3>\n                        <\/summary>\n                        <div class=\"c-faqs__answer\">\n                            <div class=\"s-cms-content\">\n                                <p>It depends on the plan. Some copayments may apply before you meet your deductible without counting toward it.<\/p>\n<p>Eligible copayments for covered in-network care generally count toward a Marketplace plan\u2019s out-of-pocket maximum.<\/p>\n                            <\/div>\n                        <\/div>\n                    <\/details>\n                                        <details class=\"c-faqs__details\" >\n                        <summary class=\"c-faqs__summary\">\n                            <h3 class=\"c-faqs__question\">What Happens After I Reach My Deductible?<\/h3>\n                        <\/summary>\n                        <div class=\"c-faqs__answer\">\n                            <div class=\"s-cms-content\">\n                                <p>Your plan generally begins paying its share of eligible expenses according to its terms. You may continue paying copayments or coinsurance until reaching your out-of-pocket maximum.<\/p>\n                            <\/div>\n                        <\/div>\n                    <\/details>\n                                        <details class=\"c-faqs__details\" >\n                        <summary class=\"c-faqs__summary\">\n                            <h3 class=\"c-faqs__question\">What Happens After I Reach My Out-of-Pocket Maximum?<\/h3>\n                        <\/summary>\n                        <div class=\"c-faqs__answer\">\n                            <div class=\"s-cms-content\">\n                                <p>Your plan generally pays 100% of covered in-network benefits for the rest of the plan year. Premiums and non-covered expenses can still be your responsibility.<\/p>\n                            <\/div>\n                        <\/div>\n                    <\/details>\n                                        <details class=\"c-faqs__details\" >\n                        <summary class=\"c-faqs__summary\">\n                            <h3 class=\"c-faqs__question\">Do Deductibles and Out-of-Pocket Maximums Reset Every Year?<\/h3>\n                        <\/summary>\n                        <div class=\"c-faqs__answer\">\n                            <div class=\"s-cms-content\">\n                                <p>They generally apply to a plan year and reset when a new plan year begins. Check your plan documents for the dates and rules that apply to your coverage.<\/p>\n                            <\/div>\n                        <\/div>\n                    <\/details>\n                                        <\/div>\n                \n        <\/div>\n    <\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":13,"featured_media":429,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-428","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/428","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/comments?post=428"}],"version-history":[{"count":5,"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/428\/revisions"}],"predecessor-version":[{"id":438,"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/428\/revisions\/438"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/media\/429"}],"wp:attachment":[{"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/media?parent=428"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/categories?post=428"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.coveragefox.com\/knowledge-center\/wp-json\/wp\/v2\/tags?post=428"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}