There are several terms to think about:

  • premium - the monthly cost of a plan
  • deductible - the amount you pay before your insurance kicks in
  • coinsurance - the amount you pay after your insurance kicks in
  • copay - also the amount you pay after your insurance kicks in
  • out-of-pocket maximum - the amount you pay before your insurance pays for everything

Two questions:

  1. Do you continue to pay your premium even after you've met your out-of-pocket maximum?
  2. Does your premium count towards your deductible or out-of-pocket maximum?
  • 1
    Welcome to health SE :-). This question is too broad, since it may vary depending on the country you are in. Moreover, it is a financial one and not related to health as specified in the help center. VTC
    – Lucky
    Mar 6 '17 at 15:02

From reading another blog post:

Unfortunately, health insurance doesn’t work that way; premiums don’t count toward your deductible.


After you’ve paid enough in deductibles, copays, and coinsurance to have reached your out-of-pocket maximum each year, your health plan begins to cover 100% of the cost of your care for the rest of the year.

You don’t have to pay any more cost-sharing that year. However, you still have to pay your monthly premiums or your health insurance policy will be canceled.

  • While this is true with every policy I've ever had, I don't believe there's anything preventing a company from writing policies with different rules. Insurance is a contract. The terms are whatever the contract says they are.
    – Carey Gregory
    Mar 4 '17 at 0:42

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