You'll pay for all of these services in full until your total expenses add up to your deductible amount. This can include doctor's visits when you're sick, a trip to an urgent care center after an injury, tests such as an MRI, and more. In the first part of your policy year, you'll pay out of pocket for many health care services beyond preventive care. Phase 1: Before you reach your deductible This can include wellness visits to your doctor and preventive screenings for issues like high blood pressure. This amount, called your premium, will stay the same throughout the year, and free preventive care is usually included. No matter what your health care needs are, you'll pay a monthly bill to have health insurance. ![]() Let's look at how these structural features of your insurance policy will work during the calendar year. When you're looking at your costs for health care and health insurance, the timing will determine whether the deductible or out-of-pocket max will be more relevant to you. ![]() After your expenditures reach this limit, you won't have any out-of-pocket costs for additional treatments and services that are covered by your policy. Your out-of-pocket max helps protect you from a worst-case scenario where you need significant medical care. Your out-of-pocket limit also works on an annual basis, and the total resets to zero in the new policy year. For example, if your out-of-pocket max is $3,000, the amount you pay for your deductible, copayments and coinsurance will be added together, and when the running total reaches $3,000, your health insurance company will start to pay the full cost for all covered health care services.
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