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by lotsofpulp
1134 days ago
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> Generally it's out of pocket maximum to a point, like $250k. Then it's normally split, something like 80-20, where you have to cover 20% of the bill. Not since the Affordable Care Act of 2010. It got rid of benefit maximums and implemented out of pocket maximum. An out of pocket maximum up to a limit is a contradiction. The situation works exactly opposite, you first pay 100% up to deductible, then you pay a proportion according to your copay, then you pay 0% after the out of pocket maximum. Annual out of pocket maximums are typically $5k to $10k for individual/family at any half decent employer. Legally, the maximums are $9.1k/$18.2k. https://www.healthcare.gov/glossary/out-of-pocket-maximum-li... |
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