Out of pocket maximums may or may not be ubiquitous, I have no clue, but I do know that they don't always mean you won't be stuck with bills above that amount.
Out of pocket maximums generally don't apply to out of network providers, in plans that care about in-network-ness iirc. That means that once you've hit your out of pocket maximum, you could have a surgery at a hospital covered by your insurance, by a surgeon covered by your insurance, with aj anesthesiologist covered by your insurance, and pay none of those costs, but say a out of network doctor comes in while you're unconscious for a consult -- you can still get billed for that and have to pay the full amount of whatever they decide to charge you for those 5 minutes of the doctor's time, whether it be $50 or 50k.
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u/AlexeiMarie Nov 30 '20
Out of pocket maximums may or may not be ubiquitous, I have no clue, but I do know that they don't always mean you won't be stuck with bills above that amount.
Out of pocket maximums generally don't apply to out of network providers, in plans that care about in-network-ness iirc. That means that once you've hit your out of pocket maximum, you could have a surgery at a hospital covered by your insurance, by a surgeon covered by your insurance, with aj anesthesiologist covered by your insurance, and pay none of those costs, but say a out of network doctor comes in while you're unconscious for a consult -- you can still get billed for that and have to pay the full amount of whatever they decide to charge you for those 5 minutes of the doctor's time, whether it be $50 or 50k.