What does Stop-loss, Coinsurance Maximum, or Maximum Out-of-Pocket mean?
Many people understand that they must meet their deductible and then they will be responsible for a percentage of costs beyond that while the insurance company pays the rest – 80/20, 70/30, 50/50 are very common “co-insurance” percentages. What many people don’t realize is that there is often a point in time where the insurance company assumes 100% of the financial responsibility for claims. Stop-loss, coinsurance maximum and maximum out-of-pocket are terms that refer to that point in time where the insurance company assumes full claim responsibility.
