Which statement about coinsurance and out-of-pocket maximum is accurate?

• A. Coinsurance continues indefinitely.
• B. There is no limit to out-of-pocket costs.
• C. Coinsurance ends after the deductible, and there is no out-of-pocket maximum.
• D. Coinsurance continues until the out-of-pocket maximum is reached.

Answer: (D)

Understanding cost sharing in health insurance is key. After you meet the deductible, you share costs with the plan through coinsurance, paying a percentage of covered services until you reach the annual out-of-pocket maximum. Once that limit is reached, the plan typically pays 100% of covered expenses for the rest of the year. This arrangement creates a safety cap on what you pay out of pocket, including deductible, coinsurance, and copays (though premiums aren’t counted toward the limit in most plans).

The statement in question reflects this relationship: coinsurance continues until the out-of-pocket maximum is reached, at which point you’re protected from higher annual costs for covered services. The other options are inconsistent with that cap—coinsurance isn’t endless, there is typically a limit to out-of-pocket costs, and there is usually an out-of-pocket maximum.