Here's my ACA rate INCREASE for those who doubt...

[Cal Carpenter]

115. 50% Coinsurance, as in the OP's example, means you pay half

of the bills until you have hit your out-of-pocket maximum of $6k (or $12k for a family) or whatever the exact amount is up there (don't feel like scrolling).

This is on top of your premium. A few things are exempt, like annual physicals (wellness). Most doctor appts beyond that, you have to pay for up to your deductible and then coinsurance on top of that up to the OOP max for the year.

This is why many people have been trying to point out that having health insurance does not always equate to affordable health *care*. If people have chronic problems that require check-ups and testing and meds, or a major accident, or some other expensive medical situation, it can be cost prohibitive. The only real upside is that if someone has a huge medical bill for hospitalization or major surgery or something, they are only responsible for their annual out of pocket maximum. But I don't know that many families that can shoulder $12k in bills on top of the premiums and deductibles. Many people and families who do not qualify for significant subsidies may still find this cost prohibitive.

Sorry for the long reply, my fingers just kept going LOL.