Regulations require every policy to have an out of pocket cap, and while insurers have attempted to prevent this sort of system, many states(including mine) have legislated that they need to count payments made on behalf of the patient toward the out of pocket cap.
When my second kid was born with EA/TEF, we had a policy for that year that ducked this, it's part of the reason it cost so much.
They labeled the hospital we were in as in-network, which one would anticipate means the doctors and care were in-network as well given surgical procedures, etc, however that isn't the case. The facility can be in-network, but doctors aren't necessarily in network and nothing you paid them contributed to anything. The problem is there isn't a lot of choice, you show up and the anesthesiologist is just who is there, for instance. We had to pay out of pocket for several doctors related to my wife and kid's care while he was in the NICU and none of it contributed towards deductibles or maxes.
It was compounded because this all went down in mid-December and neither one got out of the hospital until January, which meant in one month we racked up maxes for both years on top of all these expenses that aren't covered. I lost track of the bills after a while but it was somewhere in the realm of $60k-70k not including the $24k-$26k paid yearly for insurance.
IIRC the current administration passed or attempted to pass some rules to address this mixed labeling of networks, but idk if it went through or not, it's shady as hell. We were at least able to change providers the next year, something we planned on doing because they somehow determined the four OB visits my wife went to while pregnant weren't "medically necessary".
