out-of-pocket limit (OOP)

Under a health insurance plan, the out-of-pocket (OOP) limit is the maximum amount the covered individual will have to pay for covered health services during the policy year.

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Additional Information


Generally included within the OOP are the plan deductible, coinsurance, and co-payments.

Related Terms


The deductible is the amount the insurer will deduct from the loss before paying up to its policy...

A coinsurer is one that shares the loss sustained under an insurance policy.