September 10, 200917 yr ^ From my understanding, the "public option" would collect premiums. I stand corrected, but I have another question. According to a summary of the American Health Choices Act, "Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family." Is that the most that a premium can be? How much are typical premiums for health insurance plans?
September 10, 200917 yr I stand corrected, but I have another question. According to a summary of the American Health Choices Act, "Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family." Is that the most that a premium can be? How much are typical premiums for health insurance plans? Family of 5, around $4,600 annually
September 10, 200917 yr ^ From my understanding, the "public option" would collect premiums. from whom?
September 10, 200917 yr I stand corrected, but I have another question. According to a summary of the American Health Choices Act, "Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family." Is that the most that a premium can be? How much are typical premiums for health insurance plans? From my understanding, and this is pretty hasty, I take "out-of-pocket" to mean expenses not covered by the insurance plan. And that would be a restriction that would apply to all plans. I'm not sure how much a current health insurance plan costs, and most don't see the real price tag since they are subsidized and provided by employers.
September 10, 200917 yr From my understanding, and this is pretty hasty, I take "out-of-pocket" to mean expenses not covered by the insurance plan. And that would be a restriction that would apply to all plans. I'm not sure how much a current health insurance plan costs, and most don't see the real price tag since they are subsidized and provided by employers. Does that mean that people can't spend more than $5k of their own money on medical care that their health insurance does not cover? That sounds insane.
September 10, 200917 yr What's so bad about that analogy? I understand that healthcare and college are different, but give us the details as to why it is so bad. Let's look at Harvard for example. The government could offer a 4 year degree for free and Harvard probably wouldn't see any decline in enrollment as a direct result of it. People grow up dreaming about going to Harvard, or Duke, or Vanderbilt, or Yale. For the most part private schools do not compete with public schools. They are not in the business to make money, they are all in the business to educate. Privately run insurance companies are in the business to make money.
September 10, 200917 yr From my understanding, and this is pretty hasty, I take "out-of-pocket" to mean expenses not covered by the insurance plan. And that would be a restriction that would apply to all plans. I'm not sure how much a current health insurance plan costs, and most don't see the real price tag since they are subsidized and provided by employers. I have gone through negotations concerning health care coverage. Employers normally cover 60-70% of the premium.
September 10, 200917 yr Does that mean that people can't spend more than $5k of their own money on medical care that their health insurance does not cover? That sounds insane. Let's take my current plan, which is employer sponsored. I pay premiums each pay period, and the employer pays the lionshare of the total. If I go to the doctor, I have out of pocket limits, which means that in a year, the most I should pay would be (eg) 5000. However, that co-pays, premiums, etc, are not counted toward the 5000. But, the two claims I have had denied this year will, one for 400, and one for 300. Since these are the only two claims I've had, not being good about going to the doctor and all, I have used 0 insurance benefits this year. I have paid X$ in premiums and X$ in co-pays, and $X in out of pocket expenses.
September 10, 200917 yr Does that mean that people can't spend more than $5k of their own money on medical care that their health insurance does not cover? That sounds insane. Not sure. And if that's the case I agree with you. I imagine the restriction is to prevent policies from skimping on expensive treatment, but I don't know how that will be interpreted from a legal standpoint.
September 10, 200917 yr Does that mean that people can't spend more than $5k of their own money on medical care that their health insurance does not cover? That sounds insane. Out of pocket expense is what you will have to pay in medical bills before your insurance will pick up 100% of the tab. Most plans are 80%/20% or 90%10% until you reach your out of pocket total then the insurance pays 100%. If you knew all of this already then I never mind and I will shut up know.
September 10, 200917 yr Not sure. And if that's the case I agree with you. I imagine the restriction is to prevent policies from skimping on expensive treatment, but I don't know how that will be interpreted from a legal standpoint. The maximum OOP is great for catastrophic instances. It stinks if you're rarely ill or only have routine office visits and testing.
September 10, 200917 yr The premium that comes out of your paycheck should also be considered out of pocket.
September 10, 200917 yr The premium that comes out of your paycheck should also be considered out of pocket. It's not.
September 10, 200917 yr It's not. But in reality it is. If I would happen upon a business that pays 80% of my premium compared to one the pay 70, then I would consider that 10% difference as an out of pocket expense.
September 10, 200917 yr But in reality it is. If I would happen upon a business that pays 80% of my premium compared to one the pay 70, then I would consider that 10% difference as an out of pocket expense. It's not. Co-pays are completely separate.
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