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Comment by water554 | Hacker News Reader

Most insurance plans have an out of pocket maximum, no?

Generally it's out of pocket maximum to a point, like $250k. Then it's normally split, something like 80-20, where you have to cover 20% of the bill. That seems like a lot until you have something like cancer, where you need surgery plus chemo in the same year, which adds up quite fast.

> Generally it's out of pocket maximum to a point, like $250k. Then it's normally split, something like 80-20, where you have to cover 20% of the bill.

Not since the Affordable Care Act of 2010. It got rid of benefit maximums and implemented out of pocket maximum. An out of pocket maximum up to a limit is a contradiction. The situation works exactly opposite, you first pay 100% up to deductible, then you pay a proportion according to your copay, then you pay 0% after the out of pocket maximum.

Annual out of pocket maximums are typically $5k to $10k for individual/family at any half decent employer.

Legally, the maximums are $9.1k/$18.2k.

https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...

Yes, but it can be tens of thousands in many cases, and it does not cover many things that it should, insurance companies put deliberate effort into screwing people put of their claims.

The legal maximum is $9.1k for an individual and $18.2k for a family. At any half decent employer, it will be $5k/$10k at most.

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