[Health Insurance] 10, Out-of-Pocket Maximum and Stop-Loss Provisions

This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - The out-of-pocket maximum is the absolute most an insured will pay for covered, in-network services in a policy year. - Once the out-of-pocket limit is reached, the insurance company pays 100% of all subsequent covered costs. - Deductibles, coinsurance, and copayments for covered services are the three costs that count toward meeting the maximum. - A critical exam trap is knowing what does NOT count: monthly premiums, non-covered services, and out-of-network charges. - The terms "out-of-pocket maximum" and "stop-loss provision" are often used interchangeably on the exam to refer to the insured's spending cap. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep