Re: I have experienced health care problem this directly



Big Gun,

Check yor son's policy. Many high-deductibles have an out-of-pocket cap.

I too have a High Deductible Plan with an HSA, and it's all out of pocket up
to $2300, after which the insurance pays 80 to 90 percent, and I still pay
the rest.

However, there is an out-of-pocket cap, after which I pay nothing. Seems
it's around $13,000.

The minimum I'd pay is the $2312 in premiums, plus actual expenses if they
total less than $2300. This year, actual is estimated to be about $1800, for
a total of $4412. Insurance pays nothing (but the charges I pay are the
insurance company's discounted charges, which saves me about 35% over the
'retail' charges).

The max I would pay is the $13,000 cap. That would be the total of pemiums,
the first $2300 of actual, plus 10 to 20 percent of the amount above $2300.

Doing the math, I would 'cap-out' at about $51,232 in total medical
expenses[1].

If that is the "out-of-pocket limit" the article is referring-to, I approve
of it.

Allan

[1] To cap out, I would pay $2312 in premiums (they count toward cap), $2300
in actual expenses, and $8388 (which is 15% of charges of $47,532). The
actual billed charges of $2300 that I paid, plus the $47,532 in charges that
I paid 15%-of, equals a total billed charges of $48,932. Adding the premiums
to billed charges equals $51,232.

--
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---
True civility is when every one gives to every other one every right
that they claim for themselves.

"Big Gun" <None@> wrote in message
news:lspf95lfh9r3ss6u41imqb59tr5bn5du37@xxxxxxxxxx
I pay for a very high deductible insurance plan on my 23yo son. I have
the same problem as described in this column...



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