Copays are not necessary once what is reached?

• A. Deductible
• B. Out-of-Pocket Maximum
• C. Coinsurance
• D. Premium

Answer: (B)

The important idea is the annual out-of-pocket maximum. This is the cap on how much you pay for covered services in a year. Once you reach that limit, the plan covers 100% of the costs for covered services for the rest of the year, so you wouldn't need to pay copays anymore. Before hitting the max, you pay things like the deductible (what you pay first), coinsurance (your share after the deductible), and copays. Premiums are the regular monthly payments and aren’t tied to reaching the max.