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1 BusyMonster  Fri, Feb 21, 2014 12:41:32pm

Notice that Youtube comments are disabled. This is an almost-axiomatically clear sign that someone does not wish to be argued with, or humiliated into withdrawing their lies, and that they are full of shit, also.

2 steve_davis  Fri, Feb 21, 2014 12:51:38pm

I’m embarrassed to admit that I don’t even fully understand what I’m getting through my bronze plan. It’s 60/40, with an annual maximum out-of-pocket of 6,300 or thereabouts. Does that mean that I pay a maximum of 6,300 as part of the 60/40 part, or that I pay 6,300 out of pocket before we get to the 60/40 split of costs? I’m smart enough to where it’s embarrassing not to be able to fathom which way this works, but insurance legalese is unfathomable.

3 Snarknado!  Fri, Feb 21, 2014 1:15:33pm

re: #2 steve_davis

I’m embarrassed to admit that I don’t even fully understand what I’m getting through my bronze plan. It’s 60/40, with an annual maximum out-of-pocket of 6,300 or thereabouts. Does that mean that I pay a maximum of 6,300 as part of the 60/40 part, or that I pay 6,300 out of pocket before we get to the 60/40 split of costs? I’m smart enough to where it’s embarrassing not to be able to fathom which way this works, but insurance legalese is unfathomable.

It depends on what state you’re in and what your income level is (subsidies!), so it’s no wonder you’re confused, but there are services that are free (“preventative services”), and outside of that, you usually need to meet a deductible before copayments kick in — not necessarily the entire $6300, though.

If you ask the insurance company you signed up with for an evidence of coverage (or find it online), you should get the whole skinny on your costs.

4 blueraven  Fri, Feb 21, 2014 1:39:20pm

re: #2 steve_davis

I’m embarrassed to admit that I don’t even fully understand what I’m getting through my bronze plan. It’s 60/40, with an annual maximum out-of-pocket of 6,300 or thereabouts. Does that mean that I pay a maximum of 6,300 as part of the 60/40 part, or that I pay 6,300 out of pocket before we get to the 60/40 split of costs? I’m smart enough to where it’s embarrassing not to be able to fathom which way this works, but insurance legalese is unfathomable.

Whatever you pay out of pocket after your deductible is met is part of the $6300. So each time you make a copay, that amount goes toward the 6300 (or amount on individual plan) OOP cap.

Do not confuse OOP expense with deductibles.

here is an article that explains it pretty well.

moneyunder30.com


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