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High Deductible Out of Pocket Maximum


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Is the maximum limit for high deductible plans a combo of in and out of network or can the limit be for each type of structure? We have a shared family deductible and then individual out of pocket limits. This year we are thinking about adding an out of network structure and the costs in the network would not be credited towards the out of network limit.

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  • 1 month later...

I am not exactly sure what you are asking but the ACA does not contain any out-of-pocket maximum limits for out-of-network providers.  If you wanted to take them into account, I believe off the top of my head that HHS permits you to do it as long as you do so in a reasonable manner.

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