The unfortunate reality is that paying $2000/month to an employer managed health plan is cheaper than going through the federal government ($5,000/month for a family of 4 the last I checked). If marketplace plans had lower premiums and lower deductibles that would be the ideal option.
Here is NJ’s prices, which is a relatively high cost state:
https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcra...
For a silver level Horizon BCBS plan (Omnia Silver HSA, pretty broad coverage, never seen a provider not in network), you would be looking at $300 to $700 per person, calculated using the age rating factors at the bottom. And I know from experience the max OOP was $10k or a little less.
Even if you were older parents, the total would come in under $3k per month for a plan that covered 70% of expected healthcare expense, which is what qualifies it to be labeled silver.
I know priced in California were not too much more than NJ. There is a Kaiser pdf showing a detailed breakdown of premiums nationwide, but pretty much everywhere scales from $300 to $1k per month from age 20 to 65 for a silver level plan.
And this is all for buying via healthcare.gov. I would bet all big employers provide far more subsidized ACA compliant health insurance, so if you are employed, I would budget for employers to pay 70% of the premium, so individuals would pay 30% of $2k for family coverage = $700 per month and be subject to $5k per year deductible, and $10k oop max per year.
Basically, you can expect to insure your whole family for unlimited (in network and out of network emergency) healthcare expense for $20k per year if you work for a big company, and $40k per year if you are paying yourself, maybe $45k if you’re over 50 years old.
>Maximum out of pocket only kicks in once you’ve hit the deductible on 2+ family members, at least for our plan. So for us, the max is $20k.
Out of pocket maximum has nothing to do with deductible. Copays/coinsurance “kick in” after deductibles are reached.
If you had purchased ACA complaint health insurance, then OOP max is simply OOP max, a single number that once you reach, you do not pay further for in network services (and now for out of network emergency services also).
Edit: note that a “Marketplace” (or ACA complaint) plan explicitly transfers wealth from young and/or healthy to old and/or unhealthy, where healthy and unhealthy mean “does not need healthcare” and “needs healthcare”. So by choosing to go with a non Marketplace plan, they are placing their bets on not needing healthcare…which is probably not a winning bet for people birthing and raising young children.