What is the out-of-pocket maximum on an ACA plan?

The out-of-pocket maximum is the most you have to pay for covered in-network services in a plan year — once you hit it, the plan pays 100% of covered essential health benefits for the rest of the year, per HealthCare.gov (2026); the ACA sets an upper limit on this amount each year.

Answered by ACA Direct Answers. Read the full answer →