Often we see that a minimum amount of medical services must be purchased before any insurance coverage is activated. It might be $300 in a calendar year. If you only spend $250 in a year, none of it might be covered. Usually, reaching the minimum expenditure triggers a period of co-pays, or coinsurance, where you pay a certain amount or percent, and the insurance company pays the balance. Then, depending on how your expenses grow, you may reach your maximum out-of-pocket for the year. It might be $1,000 a year or $2,000 or higher.