General Discussion

karynnj

(60,965 posts)

50. You just need definitions of the words

Fri Oct 11, 2013, 11:34 AM

Oct 2013

Deductible is the amount that you have to have spent before the plan pays anything on the items that say "after the deductible is paid". The Maximum out of pocket caps what you have to pay for the sum of anything you paid out of pocket - including the deductible, copays or any thing where you paid a share of the cost. One way of looking at this is that no matter what catastrophic medical needs you encounter, this is the most you would have to pay for the year. (Fortunately, the vast number of us do not come near to this in most or even all years. It should not be interpreted as the likely out of pocket cost -- unless you know you are someone with extreme medical needs.)

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trying to figure out where I'm going to get the money for my obamacare [View all] datasuspect Oct 2013 OP

What do you pay now? B Calm Oct 2013 #1

negligible cost datasuspect Oct 2013 #2

lots of preventive care are no copay Motown_Johnny Oct 2013 #4

my aca options datasuspect Oct 2013 #9

Which still doesn't change the fact that preventative care jeff47 Oct 2013 #102

Preventative care is mostly stuff that is pretty useless FarCenter Oct 2013 #112

You apparently haven't seen much in the way of modern price sheets. jeff47 Oct 2013 #113

A well person wouldn't see a doctor 4 times, and hardly any of the tests apply. FarCenter Oct 2013 #115

Ah, to be young again jeff47 Oct 2013 #117

They will now....that's the point. We need wellness care...preventative medicine! VanillaRhapsody Oct 2013 #127

Preventative medicine only works if patients modify their behavior FarCenter Oct 2013 #131

going in for checkups so the doctor reminds them of that and offers treatment programs... VanillaRhapsody Oct 2013 #132

Other countries are less overweight because food costs more. FarCenter Oct 2013 #134

that is not why and you know it! VanillaRhapsody Oct 2013 #136

Fresh fruit and vegetables are cheaper in the US than Europe FarCenter Oct 2013 #138

Fresh fruits and vegetables in the united states...often do not come from the united states... VanillaRhapsody Oct 2013 #141

And the Europeans are bringing some in from Africa and the Middle East FarCenter Oct 2013 #142

Do you have proof of this contention? A link perhaps... VanillaRhapsody Oct 2013 #143

Even if you are right (which you aren't) Motown_Johnny Oct 2013 #146

preventitive care is no charge Duckhunter935 Oct 2013 #104

Do you understand the term "no copay"? Motown_Johnny Oct 2013 #124

Sounds like a great plan as long as you never get sick or injured. (nt) Nine Oct 2013 #5

it's not a plan datasuspect Oct 2013 #8

Of course, if you do get sick or injured, LWolf Oct 2013 #150

your taxable income is above $40K a year and you can't do 214 a month? Motown_Johnny Oct 2013 #3

+1 Nine Oct 2013 #6

Or the person is in poverty in a state that didn't expand medicaid HereSince1628 Oct 2013 #7

If that were the case, they'd be exempt from the mandate Orangepeel Oct 2013 #16

I'd like a link for that, please HereSince1628 Oct 2013 #20

Sure Orangepeel Oct 2013 #23

Thanks HereSince1628 Oct 2013 #32

Thanks will bookmark for LukeFL Oct 2013 #119

no, i won't tell my family to stfu datasuspect Oct 2013 #11

You must be on the higher end of that 39-60k... ScreamingMeemie Oct 2013 #13

i read as much as i could on the website to see if I was missing something datasuspect Oct 2013 #14

I would call, because something doesn't sound right. ScreamingMeemie Oct 2013 #17

i get what you're saying datasuspect Oct 2013 #19

It is for me. In the four years since I was dropped, ScreamingMeemie Oct 2013 #21

well most days datasuspect Oct 2013 #22

Is there an option with primary care and prescriptions w/o deductible? moriah Oct 2013 #38

Yes, it's called every plan in the exchanges. (nt) jeff47 Oct 2013 #105

Sadly no... several Bronze plans are deductible before anything except preventative care. moriah Oct 2013 #116

Primary care and preventative care are the same thing. jeff47 Oct 2013 #118

The SOB that was shown says 0% coinsurance to see primary care physician *after* deductible. moriah Oct 2013 #122

Because people are spewing crap about the plans. jeff47 Oct 2013 #123

If you get into a car accident, for example, 6,000 is nothing. robinlynne Oct 2013 #76

exactly. That could be $100,000+ of medical bills. ZRT2209 Oct 2013 #135

Not that it's great davekriss Oct 2013 #78

You would be getting physicals and screening tests for free. pnwmom Oct 2013 #88

Missouri and ACA won't help our family aroach Oct 2013 #36

Yes that's what is called the 'family glitch' part of the ACA which needs to be fixed but won't be PoliticAverse Oct 2013 #54

Can he only cover himself and then have you and the kids go on ACA? stevenleser Oct 2013 #62

Do your kid(s) have health insurance? Go to a pediatrician every year? snooper2 Oct 2013 #47

So the $214 a month is FAMILY coverage, or you only? n/t DebJ Oct 2013 #99

I call B.S.� regnaD kciN Oct 2013 #107

It could be parents Motown_Johnny Oct 2013 #126

nobody says it made you a millionaire Motown_Johnny Oct 2013 #125

private insurance companies want what you would save for retirement, datasuspect Skittles Oct 2013 #128

I am sure a ton of people have their funds already spoken for Mojorabbit Oct 2013 #24

The $214 monthly premium is doable. Yo_Mama Oct 2013 #37

my mom faced that choice when she was still working datasuspect Oct 2013 #43

It happens to a lot of people. Yo_Mama Oct 2013 #80

Post removed Post removed Oct 2013 #51

yours is a disgusting post jonsiee Oct 2013 #59

no it isn't, the OP is disgusting Motown_Johnny Oct 2013 #120

It's the deductible that's the killer. The 214 buys nothing until you pay $6,000 hooverville29 Oct 2013 #71

That is simply not true. Blue Idaho Oct 2013 #92

Wrong. Tons of routine and preventative care is paid for regardless of the deductible. (nt) jeff47 Oct 2013 #110

Post removed Post removed Oct 2013 #81

how about geography? TorchTheWitch Oct 2013 #144

214 is still a very small percentage of take home Motown_Johnny Oct 2013 #145

I HAVEN'T been insured for the past dozen years TorchTheWitch Oct 2013 #147

I don't think your experience is invalid Motown_Johnny Oct 2013 #148

I presently can only dream mine will be that low. mmonk Oct 2013 #10

if it was good insurance, that would be one thing datasuspect Oct 2013 #12

I currently pay over $880 a month with a $5450.00 deductable. mmonk Oct 2013 #25

well if you can pay that datasuspect Oct 2013 #26

You too. mmonk Oct 2013 #27

We have always had high "deductible" issues in our family, with "good" employer insurance. haele Oct 2013 #94

best wishes to you and your family, you are hard-pressed indeed nt steve2470 Oct 2013 #111

some can't abide the reality that alot of people don't have a spare dime at the end of the month. KG Oct 2013 #15

i've been getting up at 4 am for the past 7 or so years datasuspect Oct 2013 #18

Yeah, imagine that. SammyWinstonJack Oct 2013 #45

+1 historylovr Oct 2013 #83

Those numbers don't sound right. Sedona Oct 2013 #28

I've seen this question posed several times enlightenment Oct 2013 #79

Modified and adjusted? Talk about tax speak. BlueCheese Oct 2013 #129

Probably. enlightenment Oct 2013 #130

this is the insurance we used to have from my husband's previous employer. ejpoeta Oct 2013 #29

i'll pay anything to be responsible datasuspect Oct 2013 #30

at least they have to cover preventative care. they didn't pay out a dime ejpoeta Oct 2013 #31

Scam? displacedtexan Oct 2013 #39

What's the silver plan? Habibi Oct 2013 #33

A lot of us are in your shoes. Le Taz Hot Oct 2013 #34

+1 Puzzledtraveller Oct 2013 #35

I haven't had health care insurance for five yrs, since my husband stopped working and went on SSDI. SammyWinstonJack Oct 2013 #48

No, shut up and love it. Why do you hate America? Myrina Oct 2013 #40

I'm getting hosed too. Brigid Oct 2013 #41

I'm confused PasadenaTrudy Oct 2013 #42

You just need definitions of the words karynnj Oct 2013 #50

Deductible is what must be paid before coverage kicks in TheKentuckian Oct 2013 #52

Do you pay full price, out of pocket, for doctor visits if you are sick? Lex Oct 2013 #55

Usually, that's what a 'deductible' means hooverville29 Oct 2013 #73

But under ACA you don't. Lex Oct 2013 #75

Depends on the plan. jeff47 Oct 2013 #109

Depends on your benefit structure. Usually routine office visits are a separate copay but not always TheKentuckian Oct 2013 #121

Is the penalty affordable? JVS Oct 2013 #44

For years I managed to come up Skidmore Oct 2013 #46

Then take the $95 penalty the first year and let the market stabilize. PeaceNikki Oct 2013 #49

$95 or 1% of your income (whichever is greater) for an individual. n/t PoliticAverse Oct 2013 #87

This guy has a suggestion. You don't even need to be elderly. AnotherMcIntosh Oct 2013 #53

"We'll fix it later." Prism Oct 2013 #56

"How can we fix a problem people refuse to admit exists in the first place?" JVS Oct 2013 #66

6K for a deductible is not that high considering that... The Midway Rebel Oct 2013 #57

bankruptcy is cheaper than the deductible datasuspect Oct 2013 #58

It's high if you don't have the $6000 or a way to raise it. LWolf Oct 2013 #151

I'm confused... do you expect health insurance to be free? taught_me_patience Oct 2013 #60

No, just more expensive than bankruptcy, apparently. nt The Midway Rebel Oct 2013 #61

depends on what you mean by free datasuspect Oct 2013 #63

I'm not trying to badger you, really, I'm not. But-- Habibi Oct 2013 #67

it's a midpoint between the two extremes datasuspect Oct 2013 #69

Waaaaaaaaaaahhhhh!!!! Pretzel_Warrior Oct 2013 #64

bless your heart datasuspect Oct 2013 #65

What are YOU paying PW? B2G Oct 2013 #70

More likely his parents pay hooverville29 Oct 2013 #74

Is this going to be followed by another fake apology Union Scribe Oct 2013 #139

Nope. Pretzel_Warrior Oct 2013 #140

Suggestion: ProSense Oct 2013 #68

Can a DU explainer-n-chief explain deductibles in a new OP? ecstatic Oct 2013 #72

did we appoint one yet? datasuspect Oct 2013 #77

My *very* rudimentary knowledge: Lars39 Oct 2013 #82

As the Official Appointer, I Appoint Lars39... Phentex Oct 2013 #84

oh, gawd, no...I just jumped in there! lol Lars39 Oct 2013 #86

lol! nt ecstatic Oct 2013 #96

There are several things that likely need to be explained... PoliticAverse Oct 2013 #89

I made post #93 before I saw this. ieoeja Oct 2013 #95

Per your instructions: a new OP. ieoeja Oct 2013 #100

Great! Thanks! ! nt ecstatic Oct 2013 #137

I pay $320 a month for my family insurance. $7500 catastrophic deductible. eqfan592 Oct 2013 #85

Is that 6,000 your deductible or is it your yearly out of pocket maximum? pnwmom Oct 2013 #90

deductible datasuspect Oct 2013 #91

Can anyone explain what a medical deductible even is? ieoeja Oct 2013 #93

Wouldn't it be nice JSK Oct 2013 #97

What about the silver and gold plans? Rex Oct 2013 #98

i listed the datasuspect Oct 2013 #101

So none of the plans will work for you then? Rex Oct 2013 #103

not without some kind of subsidy datasuspect Oct 2013 #108

You're right. The Republican healthcare plan--don't get sick or die fast--is better. valerief Oct 2013 #106

I fail to see the difference. LWolf Oct 2013 #152

My mother had routine surgery for an infected gallbladder Generic Other Oct 2013 #114

What is your current insurance payment? eom melody Oct 2013 #133

You are not missing anything. LWolf Oct 2013 #149

Then pay the penalty and continue to have no insurance. You seem to think that is working fine now. bullimiami Oct 2013 #153

somethings not right! infiniti30 Oct 2013 #154

welcome to DU gopiscrap Oct 2013 #155

It's going to be an enormous and very affordable blessing for me. nt Zorra Oct 2013 #156

Yeah, welcome to du Flying Squirrel Oct 2013 #157

It's extremely affordable (screenshot enclosed) ScreamingMeemie Oct 2013 #158

Medical Deductibles are not like other Insurance Deductibles - haele Oct 2013 #159