trying to figure out where I'm going to get the money for my obamacare

[Lars39]

82. My *very* rudimentary knowledge:

You pay monthly premiums.

You need to see the doctor for the flu, for example: you pay a co-pay, the rest of the bill that you pay goes towards the deductible.

(Not sure if routine physicals that the ACA now covers is applied to the deductible...I'm thinking not applied.)

Once you meet the deductible, the insurance will start paying a percentage, say 70%.

You still pay the co-pay plus 30%(per the example).

Once you have paid what amounts to your out-of-pocket maximum, the insurance kicks in and pays %100.

Until the next year rolls around and you get to do it all over again.

You will have EOBs (explanation of benefits) for each visit mailed to you or you will be able to see them online.

Sometimes there will be multiple charges on one EOB, sometimes there will be several different EOBs for the same visit, depending on what you had done.

The insurance company and the provider(doctor, etc) have a contract that decides on "allowable charges", ie how much the insurance company has decided they will pay for things.

The provider cannot make you pay more than what was stipulated in the contract. So you may get a huge bill, but by the time the insurance company identifies the allowable charges

it is often much lower. So don't pay anything until you get a look at the EOB, and even then wait awhile because sometimes the bill is resubmitted for some reason or other.