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- Get Coverage
- A quick guide to the Marketplace
- Apply & enroll
- Getting lower costs
- Fees & exemptions
- What plans cover
- How to choose a Marketplace plan
- Reporting income and household size
- Coverage outside Open Enrollment
- Important Marketplace deadlines
- Keep or Change Your Plan
- Keep or change your plan
- Reporting life & income changes to the Marketplace
- Medicaid, CHIP & Medicare
- Medicaid & CHIP
- Medicare and the Marketplace
- Information About Health Coverage
- Using your Marketplace coverage
- Why health coverage is important
- Preventive care benefits
- Rights and protections
- Appeal a Marketplace decision
The most you pay during a policy period (usually one year) before your health insurance or plan starts to pay 100% for covered essential health benefits. This limit must include deductibles, coinsurance, copayments, or similar charges and any other expenditure required of an individual which is a qualified medical expense for the essential health benefits. This limit does not have to count premiums, balance billing amounts for non-network providers and other out-of-network cost-sharing, or spending for non-essential health benefits.
The maximum out-of-pocket cost limit for any individual Marketplace plan for 2015 can be no more than $6,600 for an individual plan and $13,200 for a family plan.