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Out-of-Pocket Limit

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The most you pay during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium balance-billed charges or heath care your health insurance or plan does not cover. Some health insurance or plans do not count for all of your co-payments, deductibles, co-insurance payments, out-of-network payments or other expenses towards this limit.