Description

The annual out-of-pocket maximum is the highest amount a patient will pay for covered healthcare services within a plan year. Once this limit is reached, the insurance plan covers 100% of the costs for covered services for the remainder of the year.

Interpreter Notes

Interpreters should be aware that patients may confuse this term with 'deductible' or 'co-payment', which are different concepts. It is important to maintain a formal register and clarify that this term refers specifically to the maximum patient expense for the year. Avoid colloquial terms that may not be understood in a clinical context.

Example Sentences

EN: The annual out-of-pocket maximum ensures that patients do not face excessive healthcare costs in a single year.

ES: La responsabilidad máxima del paciente, tope anual, asegura que los pacientes no enfrenten costos excesivos de atención médica en un solo año.

Common Interpreter Mistakes

Confusing with 'deductible'; mixing up with 'co-payment'; misinterpreting as a one-time fee