US Health Insurance Costs

The cluster focuses on discussions of premiums, deductibles, out-of-pocket maximums, and total expenses in US health insurance plans, including ACA and employer-sponsored options, with debates on affordability and coverage limits.

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Keywords

e.g US AGI PPO PCP OK LESS CPM i.e healthcare.gov deductible premiums insurance pocket plan plans health insurance health maximum pay

Sample Comments

anoncoward111 Aug 6, 2018 View on HN

He is most likely paying premiums and co pays close to $300 anyway

ac29 Jul 7, 2022 View on HN

There are annual out of pocket maximums. Mine is something like $7000 last I checked. Its a lot of money, but not an amount that would bankrupt most people.

Cerium Nov 9, 2016 View on HN

As a fairly young US citizen I'm curious, I thought that most health care plans have an out of pocket maximum that is usually in the low to mid thousands per year. Would this situation not be one that limits the yearly cost that way?

prepend Dec 27, 2022 View on HN

That’s pretty fancy insurance. Check out healthcare.gov and you’ll find many plans where the premium plus deductible are much lower than $20k.

_heimdall Oct 28, 2024 View on HN

I pulled insurance quotes for my wife and I recently. Both of us are young and with no known health issues. Our monthly premiums for the cheapest plan was around $800 per month, but that was with very limited coverage and a deductible of around $15,000 before they would cover any major expenses.The premiums would be $9,600 a year but all in we could spend around $25,000. We had options for higher premiums and lower deductibles as well, but the total max out of pocket was almost identic

daxorid Jan 9, 2017 View on HN

I pay 780$/mo for a plan with a $13k max out of pocket. Where on earth are you getting 45$ ?

vel0city Jan 10, 2022 View on HN

Many (most? I always take employer-sponsored, not an expert on all plans) health insurance plans in the US have a concept of out-of-pocket max. This is a yearly amount that is essentially your maximum yearly liability. That amount can vary from plan to plan and year to year. Usually a lower out of pocket max means higher premiums, similar to the idea of having a lower car insurance deductible usually means higher premiums.It looks like all plans sold through the healthcare.gov marketplace is

lotsoweiners Aug 23, 2025 View on HN

Please explain because it sounds like you might not have as good of insurance as you think. I have good insurance and pay basically nothing out of pocket beyond around $200 deductible.

toasterlovin Dec 7, 2019 View on HN

Something is not adding up here. Health insurance in the US has annual out of pocket maximums that would have limited his total payments for the incident and all subsequent care to something like $15k/year for his entire family.

bawana Mar 2, 2018 View on HN

no it doesnt work. the insurance companies restrict reimbursement even for those people who pay premiums. I have seen deductibles now in the $5000 to $10000 range. The costs and fees have been inflated beyond reality to facilitate their profit numbers for their EPS ratios.