The most you pay during a policy period (which is usually a calendar year) before your health insurance or plan starts to pay 100% for covered essential health benefits. This limit includes your deductibles, your co-insurance, co-payments or other charges, required of an individual which is a qualified medical expense for essential health benefits. This limit does not count premium balance billing amounts or spending for non-essential health benefits.

As mentioned in my previous post,the maximum out of pocket limit for any individual “market place” plan for 2015 can be no more than $6,600 for an individual or $13,200 for a family plan. If you have medical needs that have been unmet and you have met your maximum out of pocket expense, you may want to schedule procedures yet this year. If you are a Wellmark policy holder, you could go to www.mywellmark.com to track this topic. I encourage you while you have a little downtime from work over the holidays to download this handy tool.