Post by gale w on Dec 7, 2019 3:35:23 GMT
It's that time of year again. 
The plans we can afford all have pretty high deductibles. Anywhere from 6000 to 8000+ per person (max 2 per family). The maximum out of pocket is just a bit higher than the deductible in most cases, and in some cases it's the same. From my research the maximum out of pocket includes paying the deductible, copays and any other medical costs.
One plan, for example, pays 50% after the deductible of $7700 is met, but the maximum OOP is only $450 higher than the deductible at $8150. So would you even worry about the copay being so high? Since nothing is covered until the deductible is met, and any bills after that go toward the max oop and then your max oop is met once you've paid $450 of the bills, so everything is 100% covered. Does that make sense? I was shying away from plans with a high coinsurance after the deductible is met but if the max oop is so close it doesn't really matter, right?
this is just one example of plans we can choose from. Some have lower deductibles but none are below 6000. We now have 2 companies to choose from in our state/county and the company we currently have claims to not cover my gyn or my daughter's gp (even though they have in the past). She doesn't mind changing doctors but I'm kind of attached to my gyn.
The plans we can afford all have pretty high deductibles. Anywhere from 6000 to 8000+ per person (max 2 per family). The maximum out of pocket is just a bit higher than the deductible in most cases, and in some cases it's the same. From my research the maximum out of pocket includes paying the deductible, copays and any other medical costs. One plan, for example, pays 50% after the deductible of $7700 is met, but the maximum OOP is only $450 higher than the deductible at $8150. So would you even worry about the copay being so high? Since nothing is covered until the deductible is met, and any bills after that go toward the max oop and then your max oop is met once you've paid $450 of the bills, so everything is 100% covered. Does that make sense? I was shying away from plans with a high coinsurance after the deductible is met but if the max oop is so close it doesn't really matter, right?
this is just one example of plans we can choose from. Some have lower deductibles but none are below 6000. We now have 2 companies to choose from in our state/county and the company we currently have claims to not cover my gyn or my daughter's gp (even though they have in the past). She doesn't mind changing doctors but I'm kind of attached to my gyn.
