3 ms·

Actually, annual maximums on ("essential") benefits are illegal under the ACA[1] - the only "annual maximums" allowed are for {deductible, out of pocket}, at wh

Actually, annual maximums on ("essential") benefits are illegal under the ACA[1] - the only "annual maximums" allowed are for {deductible, out of pocket}, at which point they are supposed to cover 100% of covered claims. I don't obviously see the specific anecdote you're discussing in the thread, so I can't tell if what transpired is because it (somehow) didn't blow either of those thresholds, or because it wasn't an "essential" benefit, or simply pre-dated those terms of the ACA becoming effective. [1] - http://www.hhs.gov/healthcare/about-the-law/benefit-limits/index.html http://www.hhs.gov/healthcare/about-the-law/benefit-limits/i...

ssmoot 10y ago
Thanks for correcting me. I could've sworn I saw annual maximums when I looked on healthcare.gov but maybe I mistook the max out of pocket for a max annual. The example I used is the case presented in the video. I just googled for Bob Weinkauf. http://writingshares.com/cnn-anderson-cooper-medical-news-video-bob-weinkauf-gets-474000-hospital-bill/ http://writingshares.com/cnn-anderson-cooper-medical-news-vi... I was also curious when this happened. Looks likely to be under the ACA unless it took years to hit the news though. So I don't know. Maybe he went to the emergency room and it was out of network under his plan, leaving him to shoulder the costs. I didn't dig much after skimming for an approximate date.