Life & Health · Question-card directory

QUESTION CARD Q066 · HEALTH PLANS & COSTS

Out-of-Pocket Limit

Understand the answer, compare the alternatives, and review the related terms.

CARD Q066

Which payment generally does NOT count toward a plan’s in-network out-of-pocket maximum?

  1. Covered in-network deductible payments
  2. Covered in-network copayments
  3. Covered in-network coinsurance
  4. Monthly premiums
CORRECT ANSWER · D

Monthly premiums

The out-of-pocket maximum limits qualifying cost sharing. Premiums and noncovered services generally do not count toward it.

Why each choice is right or wrong

A. Covered in-network deductible payments

Incorrect. Qualifying covered in-network deductible payments generally count.

B. Covered in-network copayments

Incorrect. Qualifying covered in-network copayments generally count.

C. Covered in-network coinsurance

Incorrect. Qualifying covered in-network coinsurance generally counts.

D. Monthly premiums

Correct. The out-of-pocket maximum limits qualifying cost sharing. Premiums and noncovered services generally do not count toward it.

Review the related terms

Use these lessons to revisit the concepts and try additional practice questions.

Sources & further reading