Deductible vs. Out-of-Pocket Max: The Difference That Costs Money

The deductible is where coverage starts

It's what you pay before the plan begins sharing costs. A $9,000 deductible means you're effectively self-insured until you've spent $9,000.

The out-of-pocket max is where your exposure stops

It's the most you can pay in a plan year, including the deductible and coinsurance. Past it, the plan pays everything covered.

This is the number that protects you from catastrophe — and it's the one people forget to compare.

Coinsurance sits between them

After the deductible and before the max, you and the plan split costs. 'Often 40% on you' is a real marketplace figure, and on a large bill it's a lot of money.