# 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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"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...

.