Out of pocket does not mean what normal people think it should mean. Your actual out of pocket can be far larger, up to unlimited.
First, every dollar you pay does not count towards the insurance company tally of "out of pocket". Often it is a tiny fraction. I've personally had years where my true out of pocket was in the several thousands but according to the insurance company my "out of pocket" was less than $100. With that kind of multiplier you can see one can easily spend many tens of thousands before reaching the nominal limit according to insurance company. How do they do this? Because they can and there's nothing to stop them.
Also, insurance plans have caps on what they'll pay. End up in the hospital for months and exceed the limits and it's all out of pocket, which can be in the millions.
Also, these don't include things like prescriptions. A friend (working at a FAANG in SV) spends about $50K/year out of pocket on medicines for chronic conditions.
First, every dollar you pay does not count towards the insurance company tally of "out of pocket". Often it is a tiny fraction. I've personally had years where my true out of pocket was in the several thousands but according to the insurance company my "out of pocket" was less than $100. With that kind of multiplier you can see one can easily spend many tens of thousands before reaching the nominal limit according to insurance company. How do they do this? Because they can and there's nothing to stop them.
Also, insurance plans have caps on what they'll pay. End up in the hospital for months and exceed the limits and it's all out of pocket, which can be in the millions.
Also, these don't include things like prescriptions. A friend (working at a FAANG in SV) spends about $50K/year out of pocket on medicines for chronic conditions.