Originally Posted by Msmith
The OOP cost for some plans have high deductible, i.e. $10000. The scenario in #10 has a OOP cost of $6500 (deductible) but zero premium.
Max out of pocket is kind of the opposite of a deductible. The deductible, as you seem to understand, is the amount you pay before insurance kicks in. The out of pocket max (OOPM) is the most you have to pay (deductible plus coinsurance) before insurance takes over at 100%.