Your deductible is the amount you'll pay in a single year for covered services before your insurance coverage begins paying for some of your care. Your out-of-pocket maximum is the most you'll pay in a single year before your insurance covers 100% of your medical expenses and bills. As mandated by the ACA, your annual maximum out-of-pocket is $8,700 for individual plans and $17,400 for family plans. Your insurance premium doesn't count towards either your deductible or your out-of-pocket expenses.