4 ms·

I thought there are 'out of pocket maximums' set by the government to avoid that? The most that individuals will have to pay out-of-pocket in 2020 is $8,200 and

I thought there are 'out of pocket maximums' set by the government to avoid that? The most that individuals will have to pay out-of-pocket in 2020 is $8,200 and $16,400 for families.

aphextron 6y ago
>The most that individuals will have to pay out-of-pocket in 2020 is $8,200 and $16,400 for families. If you have good insurance, sure. If you're unemployed, one bad illness or injury means instant bankruptcy.
- zeroonetwothree 6y ago
  We have ACA now, anyone can get affordable insurance.
  - aphextron 6y ago
    Sure, if you have $500 a month laying around no problem.
    - dunnevens 6y ago
      In many states right now, there are zero cost premiums for those who make within 200-250% of the Federal Poverty Line. Percentage varies between states, or sometimes even by counties. This was part of Biden's stimulus package and should help a lot of people.
      - URSpider94 6y ago
        In many states. Not in all.
        dunnevens 6y ago
        I mentioned it wasn't in all states. But it's still going to affect the premiums of millions. It's a good thing.
      - pmiller2 6y ago
        Yes, and there are a lot of people trapped in the land of "can't afford the insurance, but also don't qualify for subsidies."
  - ljp_206 6y ago
    The conundrum is that anyone who can afford to shell out $500+ a month for the most basic plan doesn't need it / probably has a better plan through work. The complexity and cost of the band aid system we have now is a joke the world over.
  - heavyset_go 6y ago
    Tell that to the millions of people who live in states that never expanded Medicaid under the ACA.
  - knz_ 6y ago
    No, they can't. When I was poor and working full-time for $15/hr the best I could get was a bare minimum healthcare plan that would have taken more than the free money I had after rent and food for the month -- and this was despite not paying any cost for transportation to work and not owning a car or buying anything besides rent, food and the cheapest MVNO phone plan I could find. I didn't live in a high CoL area either. Everyone who isn't wealthy or socially connected to get a job that pays above average is priced out of visiting a doctor at all right now.
  - tshaddox 6y ago
    This is ludicrously far from the truth.
- aidenn0 6y ago
  There's a huge set of caveats for the maximum out-of-pocket. The maximum is only for "in network" care. You can very easily end up with out-of-network care for various reasons (including going to an in-network hospital but being treated by a doctor who is out-of-network without being informed of this fact). Maximum out-of-pocket for out-of-network is $40k per person per year on my insurance.
KaiserPro 6y ago
To put that in context, in the UK the average wage is £38k (we have a much wider distribution than on the continent) The most we'd pay in tax is £8k: https://listentotaxman.com/38000 https://listentotaxman.com/38000? that covers all our health insurance as well. There is no copay, there are no "your condition isn't covered anymore". The only issue now is wait times, but thats because we're balls deep in a pandemic.

I thought there are 'out of pocket maximums' set by the government to avoid that? The most that individuals will have to pay out-of-pocket in 2020 is $8,200 and $16,400 for families.

aphextron 6y ago

>The most that individuals will have to pay out-of-pocket in 2020 is $8,200 and $16,400 for families. If you have good insurance, sure. If you're unemployed, one bad illness or injury means instant bankruptcy.

zeroonetwothree 6y ago
We have ACA now, anyone can get affordable insurance.
- aphextron 6y ago
  Sure, if you have $500 a month laying around no problem.
  - dunnevens 6y ago
    In many states right now, there are zero cost premiums for those who make within 200-250% of the Federal Poverty Line. Percentage varies between states, or sometimes even by counties. This was part of Biden's stimulus package and should help a lot of people.
    - URSpider94 6y ago
      In many states. Not in all.
      - dunnevens 6y ago
        I mentioned it wasn't in all states. But it's still going to affect the premiums of millions. It's a good thing.
    - pmiller2 6y ago
      Yes, and there are a lot of people trapped in the land of "can't afford the insurance, but also don't qualify for subsidies."
- ljp_206 6y ago
  The conundrum is that anyone who can afford to shell out $500+ a month for the most basic plan doesn't need it / probably has a better plan through work. The complexity and cost of the band aid system we have now is a joke the world over.
- heavyset_go 6y ago
  Tell that to the millions of people who live in states that never expanded Medicaid under the ACA.
- knz_ 6y ago
  No, they can't. When I was poor and working full-time for $15/hr the best I could get was a bare minimum healthcare plan that would have taken more than the free money I had after rent and food for the month -- and this was despite not paying any cost for transportation to work and not owning a car or buying anything besides rent, food and the cheapest MVNO phone plan I could find. I didn't live in a high CoL area either. Everyone who isn't wealthy or socially connected to get a job that pays above average is priced out of visiting a doctor at all right now.
- tshaddox 6y ago
  This is ludicrously far from the truth.
aidenn0 6y ago
There's a huge set of caveats for the maximum out-of-pocket. The maximum is only for "in network" care. You can very easily end up with out-of-network care for various reasons (including going to an in-network hospital but being treated by a doctor who is out-of-network without being informed of this fact). Maximum out-of-pocket for out-of-network is $40k per person per year on my insurance.

KaiserPro 6y ago

To put that in context, in the UK the average wage is £38k (we have a much wider distribution than on the continent) The most we'd pay in tax is £8k: https://listentotaxman.com/38000 https://listentotaxman.com/38000? that covers all our health insurance as well. There is no copay, there are no "your condition isn't covered anymore". The only issue now is wait times, but thats because we're balls deep in a pandemic.