r/FluentInFinance • u/The-Lucky-Investor • 11d ago

“Medicare for All” would save the U.S $5.1 Trillion over 10 years Discussion/ Debate

https://www.commondreams.org/news/2018/11/30/easy-pay-something-costs-less-new-study-shows-medicare-all-would-save-us-51-trillion
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u/Notcreative-number 11d ago

More and more employers are pushing the high deductible plans. There's no copays, you just pay for everything non-preventative up to an annual max.

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u/bloodphoenix90 11d ago

ah, i guess i just had decent insurance last time. $2000 out of pocket max and low copays for visits to your primary. Specialists will cost a higher bill of course.

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u/bailtail 11d ago

Yep. Insurance doesn’t pay shit for me until I’ve spent $2800.

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u/Fluffy-Bee-Butts 10d ago

Do they pay for everything after that?

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u/Mastershroom 10d ago

Most insurances have two amounts that matter; the deductible, and out-of-pocket maximum. The deductible is the amount that you have to pay full price on your own for any medical expense before insurance even starts pitching in. Once you meet your deductible, they often have co-insurance percentages, which is the percentage that you still pay for additional medical expenses and the insurance covers the rest. The OOP maximum is a much higher amount where if you spend that much on medical expenses, then the insurance takes over and pays everything beyond that amount and you don't spend any more of your own money for the rest of the year.

For example, my deductible for in-network medical expenses is $3,200. So any doctor visits or exams or tests or procedures are paid entirely by my own money until I've spent $3,200, at which point Aetna starts covering part; I don't remember off the top of my head but I believe my co-insurance is 20% for most things once I meet my deductible, so if I've spent $3,200 already this year and I have a hospital visit that costs $1,000, I'd end up paying $200. And my OOP max for in-network is $7,000, so if I manage to spend 7 grand on medical expenses this year, then I'm done paying for any more for the year.

For out of network stuff, it's even more brutal; $10,000 deductible and $20,000 OOP maximum lmao.

That said, I chose this plan because my employer pays my entire premium, and I work at an urgent care clinic where I can be seen as a patient for a flat $50 instead of having to pay the full cost of a visit ($205) towards my deductible. So I just have to hope nothing goes horribly wrong with me lol.