Need help understanding this part of health insurance…

Hello, I am working on getting our finances is better order. Part of this is debt tracking and we have some debt from hospital bills, etc.

I’ve had an HRA. To my general understanding, the employer puts in an HRA to cover the insurance deductible costs (say 10k). Then there is a difference between the deductible and out-of-pocket maximum. We’re responsible for that difference (say 3k).

Here’s where I get confused, if we reached that out of pocket max claim amount last year, does that mean that insurance kicks in 100%? Is it TRULY 100% as in they cover medical expenses in full? Or are they still selective about what and how much of it they cover (which to me defeats the purpose)?

Lastly, if the total amount of claims meet the out of pocket max near the end of the year, wouldn’t that cover any larger bills from previously earlier in the year?

We had a large bill come in and that claim hit and exceeded the out of pocket max claim requirement. Yet, i still seem responsible for that bill in full. I feel confused and welcome any guidance.

submitted by /u/Wooden_Radish180
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