Licensed Product Advisors Coinsurance Out-of-pocket Maximum
The Coinsurance out-of-pocket maximum is the limit on the amount you pay for covered health services (during the calendar year for most plans), after you have paid your deductible and excluding any copays. Plans generally pay all covered costs (except copays) for the rest of the year after you reach this limit. This limit includes only amounts paid for covered services. For example, out-of-network reductions or claims for cosmetic treatment do not count toward the coinsurance out-of-pocket maximum. Amounts in excess of the non-network reimbursement amount also do not apply to the coinsurance out-of-pocket maximum.