A health plan has a $2,000 deductible, 20% coinsurance, and a $7,500 out-of-pocket maximum. Once the insured reaches the out-of-pocket maximum, in-network covered services for the rest of the plan year are paid at:

Explanation

The out-of-pocket maximum (sometimes called the MOOP) is the annual cap on a member's cost-sharing for in-network essential benefits. Once it is reached, the plan must pay 100% of covered in-network services for the remainder of the plan year.