ACA Health Insurance
What is the ACA out-of-pocket maximum in 2026?
The ACA out-of-pocket maximum in 2026 is $9,450 for individual coverage and $18,900 for family coverage. After reaching the out-of-pocket maximum, the plan pays 100% of covered in-network services for the rest of the year. The out-of-pocket maximum applies to deductibles, copays, and coinsurance.
Key Points
- 2026 ACA out-of-pocket maximum: $9,450 individual, $18,900 family
- After OOP max: plan pays 100% of covered in-network services
- Applies to deductibles, copays, and coinsurance
- Out-of-network costs may not count toward the OOP max
- An independent agent can help you compare ACA plans based on out-of-pocket costs