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In regards to Maximum Family Liability, if someone is responsible for $5000, but their care goes over this, who pays?

1 Answer

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Final answer:

If a person's medical expenses exceed their Maximum Family Liability limit, the insurance company usually pays the additional costs according to the terms of the insurance policy, often involving coinsurance or deductibles.

Step-by-step explanation:

When considering Maximum Family Liability, if an individual is responsible for $5000 but their care exceeds this amount, the responsibility for payment generally falls on the insurance company through mechanisms such as coinsurance or a high deductible health plan. For example, after the individual reaches the stipulated maximum out-of-pocket expense, the insurance company may cover 80% of additional costs. In other scenarios, the insurance company collects premiums from policyholders to pool funds which are then used to pay for expenses that exceed an individual's maximum liability.

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