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About $7500. I would be surprised if your costs are radically different - be sure to account for any employer or government subsidy for health insurance premium

About $7500. I would be surprised if your costs are radically different - be sure to account for any employer or government subsidy for health insurance premiums. Also, those numbers include only in-network providers. If I am given out-of-network care - which isn't always under my control - then I could potentially be on the hook for tens of thousands more dollars.

bduerst 10y ago
But the concept of in-network and out-of-network coverage isn't a new to the ACA, or that different. There are plans with national network coverages - so why are you going out of network?
- Amezarak 10y ago
  I wouldn't deliberately, but there are plenty of situations where someone might inadvertently be given out-of-network care. - An out-of-network providers gives you medical attention at an in-provider facility - maybe your ER doctor, surprise, is not in-network, even though the hospital is in-network. [1] [2] [3] - Maybe you have a medical emergency and the closest facility at the time is out-of-network. (In some states and with some insurers under some circumstances, you can get them to pay the difference for emergency out-of-network care.) The biggest risk factor is the "normal" <= $7500 medical bill from an in-network provider, but inadvertent out-of-network care is still something you have to be concerned about. Also, I'm not sure if I'm reading you right, but "in-network" does not necessarily have anything to do with geography - sure, there exist in-network providers for my insurance throughout the country, but the second-closest hospital to me is still out-of-network. [1] http://justcareusa.org/beware-of-out-of-network-er-bills/ http://justcareusa.org/beware-of-out-of-network-er-bills/ [2] http://www.consumerreports.org/cro/news/2014/10/protect-yourself-from-surprise-out-of-network-medical-bills/index.htm http://www.consumerreports.org/cro/news/2014/10/protect-your... [3] http://www.realclearhealth.com/articles/2017/01/09/in_through_the_out_door_a_comprehensive_look_at_surprise_medical_bills__110368.html http://www.realclearhealth.com/articles/2017/01/09/in_throug... EDIT: The HN backoff must be crazy high - 40 minutes later, and I still can't post, and I'll be offline the rest of the day. Because the ACA didn't fix it. From my perspective, it was largely a giveaway to private insurance companies with some fortunate side effects. The total cost for my health insurance premiums are 20k a year. My in-network deductible is $4500. My in-network out of pocket is $7500. My out-of-network out of pocket is $20k. Those are not hypotheticals, and because of those costs, I avoid medical care unless it is absolutely necessary. I'm afraid we're getting into the weeds - my main point is that the ACA's preventative care provisions are really quite weak and don't mean what we might think they'd mean; the preponderance of high deductibles and out-of-pocket maximums mean that people will continue to avoid getting prompt medical care until their condition becomes serious. The preventative benefit, mainly, is that everyone gets a yearly physical and a few other narrow types of preventative care.
  - bduerst 10y ago
    Again, that's a characteristic of network coverage for health insurance. It has nothing to do with ACA so why criticize the ACA for it? You also said that your costs were 20k a year, but now you're talking about hypotheticals?

bduerst 10y ago

But the concept of in-network and out-of-network coverage isn't a new to the ACA, or that different. There are plans with national network coverages - so why are you going out of network?

Amezarak 10y ago
I wouldn't deliberately, but there are plenty of situations where someone might inadvertently be given out-of-network care. - An out-of-network providers gives you medical attention at an in-provider facility - maybe your ER doctor, surprise, is not in-network, even though the hospital is in-network. [1] [2] [3] - Maybe you have a medical emergency and the closest facility at the time is out-of-network. (In some states and with some insurers under some circumstances, you can get them to pay the difference for emergency out-of-network care.) The biggest risk factor is the "normal" <= $7500 medical bill from an in-network provider, but inadvertent out-of-network care is still something you have to be concerned about. Also, I'm not sure if I'm reading you right, but "in-network" does not necessarily have anything to do with geography - sure, there exist in-network providers for my insurance throughout the country, but the second-closest hospital to me is still out-of-network. [1] http://justcareusa.org/beware-of-out-of-network-er-bills/ http://justcareusa.org/beware-of-out-of-network-er-bills/ [2] http://www.consumerreports.org/cro/news/2014/10/protect-yourself-from-surprise-out-of-network-medical-bills/index.htm http://www.consumerreports.org/cro/news/2014/10/protect-your... [3] http://www.realclearhealth.com/articles/2017/01/09/in_through_the_out_door_a_comprehensive_look_at_surprise_medical_bills__110368.html http://www.realclearhealth.com/articles/2017/01/09/in_throug... EDIT: The HN backoff must be crazy high - 40 minutes later, and I still can't post, and I'll be offline the rest of the day. Because the ACA didn't fix it. From my perspective, it was largely a giveaway to private insurance companies with some fortunate side effects. The total cost for my health insurance premiums are 20k a year. My in-network deductible is $4500. My in-network out of pocket is $7500. My out-of-network out of pocket is $20k. Those are not hypotheticals, and because of those costs, I avoid medical care unless it is absolutely necessary. I'm afraid we're getting into the weeds - my main point is that the ACA's preventative care provisions are really quite weak and don't mean what we might think they'd mean; the preponderance of high deductibles and out-of-pocket maximums mean that people will continue to avoid getting prompt medical care until their condition becomes serious. The preventative benefit, mainly, is that everyone gets a yearly physical and a few other narrow types of preventative care.
- bduerst 10y ago
  Again, that's a characteristic of network coverage for health insurance. It has nothing to do with ACA so why criticize the ACA for it? You also said that your costs were 20k a year, but now you're talking about hypotheticals?