What happens after the out-of-pocket maximum is reached?

Prepare for the APTA Physical Therapy Test. Utilize multiple choice questions with hints and answers. Achieve excellence in your exam!

Multiple Choice

What happens after the out-of-pocket maximum is reached?

After you reach the out-of-pocket maximum, your insurance covers 100% of the costs for covered services for the rest of the plan year. This cap means you no longer pay coinsurance or copays for those in-network, covered services, though premiums aren’t counted toward the max and some plans have nuances for out-of-network or non-covered services. The other statements don’t fit because reaching the max does not stop insurance from paying, it doesn’t require you to pay everything for the remainder of the year, and it isn’t limited to just preventive services.

After you reach the out-of-pocket maximum, your insurance covers 100% of the costs for covered services for the rest of the plan year. This cap means you no longer pay coinsurance or copays for those in-network, covered services, though premiums aren’t counted toward the max and some plans have nuances for out-of-network or non-covered services. The other statements don’t fit because reaching the max does not stop insurance from paying, it doesn’t require you to pay everything for the remainder of the year, and it isn’t limited to just preventive services.

More practice questions