So some aspect of the coverage might be a 20% coinsurance, where you pay the full cost up to the deductible and then pay 20% of the cost after that until you have reached the out of pocket maximum.
Most of the fees you pay count against both of them, so like if you pay $35 to visit your primary care doctor, you are $35 closer to meeting your deductible, and then also $35 closer to reaching your out of pocket maximum. Lots of frequently used services are covered as a fee based co-pay rather than as coinsurance.
If you have a major expense for something that is covered as 20% coinsurance, the amount up to the deductible would be 100% out of your pocket, and then the coverage would kick in and pay for 80% of the rest (until your 20% exceeds the out of pocket maximum).
I kind of wonder if disallowing insurance companies to negotiate deals with providers would actually end up improving things a lot (because it would create pressure to normalize prices vs fucking around to save a little bit).
But if the provider can't communicate with the insurance in order to figure that out, why would a different deductible/coinsurance change that?
I was actually told that I met my deductible in 2022, and then I got another big bill in the mail. So that made me think deductibles are a scam and I should just pick the plan with the lowest premium.
(Thanks a lot for answering my questions by the way!)