For any plan sold on a marketplace in 2017, your maximum out-of-pocket cost can be no more than $7,900 for an individual plan and $15,800 for a family plan. Many plans have lower out of pocket maximums.
Once you reach your maximum, your insurance company pays 100 percent of your covered essential health benefits from in-network providers. This limit must include deductibles, coinsurance, copayments, or similar charges and any other qualified medical expenses. It does not include premiums, balance billing amounts for non-network providers and other out-of-network cost-sharing, or spending for non-essential health benefits.
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