[verall]

Under the ACA, the out of pocket maximum for a marketplace plan cannot be larger than $9100 for an individual and $18200 for a family in 2023.

The US healthcare system is broken but if you had insurance they could not take your whole 401k.

[smnrchrds]

If the woman was uninsured, would she be able to purchase insurance outside of the annual open enrolment period or would she need to pay out of pocket until November?

[kevingadd]

Insurance does not cover all health expenses, there are maximums and deductibles. Sometimes a treatment isn't covered.

[PragmaticPulp]

> Insurance does not cover all health expenses, there are maximums and deductibles. Sometimes a treatment isn't covered.

Lifetime and annual insurance limits aren't legal any more. It's incorrect to say that insurance has maximums.

Tuberculosis treatment for an active, diagnosed TB infection would be considered an Essential item and therefore would be covered. It's also incorrect to suggest that insurance might just choose not to cover it.

[kevingadd]

Insurance companies can and will reject treatments recommended by a doctor on a regular basis. It's not hard to find examples of this. You can insist that The Rules say TB is exempt from this but laws aren't real unless the people responsible for enforcing the rules believe in them. Do you think some faceless health insurance administrator - whose name you don't even know - is going to go to prison for rejecting your TB treatment? Have fun with months of appeals and maybe having to retain a lawyer to get your treatment.

I've personally dealt with this post-ACA (though not for TB).

[marcus0x62]

Sigh. Lifetime limits on covered procedures aren’t allowed. That isn’t to say the treatment your doctor recommends will be deemed medically necessary and be covered.

[Teever]

> Tuberculosis treatment for an active, diagnosed TB infection would be considered an Essential item and therefore would be covered.

As a non American who doesn't know much about the American healthcare system beyond what the internet and news tell me I so want to believe what you're saying but something tells me that there's at least one person out there right now in the US walking around with untreated TB because treatment wasn't classified as essential by some uncaring bureaucrat.

[PragmaticPulp]

> As a non American who doesn't know much about the American healthcare system beyond what the internet and news tell me I so want to believe what you're saying

You don't need to trust me. It's really easy to Google: https://www.healthcare.gov/coverage/what-marketplace-plans-c...

> but something tells me that there's at least one person out there right now in the US walking around with untreated TB because treatment wasn't classified as essential by some uncaring bureaucrat.

No, TB is treated as a significant public health threat. No insurance company would dare deny treatment for TB because the ensuing liability would be massive. They'd be on the receiving end of gigantic lawsuits from everyone who was possibly exposed to the person, not to mention on the receiving end of legal inquiries from the government to punish them for very clearly violating the very clear federal laws on the matter.

The US has a lot of room to improve, but it's not like the cartoonishly evil version you read about online.