The ACA caps out-of-pocket costs

The Affordable Care Act (ACA) places caps on how much money people with health insurance have to spend on health services covered in the law’s essential health benefits package. The out-of-pocket spending caps follow a sliding scale: ACA PaperworkThose with lower and middle incomes pay less out-of-pocket than those with higher incomes. The caps ensure that consumers do not incur more than a set annual amount in expenditures for covered health services. 

It is important to note that the out-of-pocket limit does not include:

  • Monthly health insurance premiums
  • Anything spent on services your plan doesn't cover
  • Out-of-network care and services
  • Costs above the allowed amount for a service that a provider may charge