Your out-of-pocket maximum is the most you will be required to pay for covered health care services in a year. After reaching your out-of-pocket maximum, you’ll no longer pay co-insurance or copays, and your insurance pay 100 percent of your medical bills. Your out-of-pocket maximum only applies to covered services. You are still responsible for any care you get that’s not covered by your policy. You’ll also continue to pay your monthly premiums.