OOP maximums can be the real killer for those with chronic conditions. But at lower to middle income levels even OOP max isn’t always that bad in ACA plans.
Re:The Ultimate Guide to Inflation
by lotsofpulp on Sunday May 09, 2021 @10:59PM
(#27102246)
OOP max is just a trade off for higher premiums. Either you pay more per month for lower OOP max, or you pay more when the healthcare expenses happens. They’re all actuarially equivalent, per the metal levels of ACA.
If anything, people should chose the high deductible high OOP max HSA plan so you can take advantage of tax benefits.
They're not actuarially equivalent if you qualify for "enahnced cost sharing" subsidies: https://www.healthinsurance.org/obamacare/the-acas-cost-shar...
Re:The Ultimate Guide to Inflation
by lotsofpulp on Monday May 10, 2021 @09:08AM
(#27105562)
Interesting, did not know about that. But 250% of federal poverty level is
> For coverage effective in 2021, 250 percent of the federal poverty level in the continental U.S. is $31,900 for a single individual, $54,300 for a family of three, and $87,900 for a family of six. (These amounts are higher in Alaska and Hawaii, since they have higher federal poverty levels).
That’s rough for a household of two, especially if they live in a high tax state.
I do not know what the ACA subsidies are for people, but the ~$17k annual out of pocket maximum is what kills you. A single heart attack or stroke at the end of the year will cost you $34k (assuming you need healthcare in two calendar years today, who knows how much 2 decades in the future).
Plus, of course, surprise bills from out of network providers.