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<blockquote data-quote="dmac1" data-source="post: 4842711" data-attributes="member: 60252"><p>You MUST have an annual out of pocket cap on deductibles that may be lower than you think. Your annual out of pocket under the AC is capped at about 10% of income. So even if your plan states a $6000 deductible, your personal cost may be lower even if you are not on an exchange plan. You may need to claim a credit on your taxes, or fill out some extra forms, but if you are only earning $40k for example, you may have options to continue care/therapy, and once you know you are going to be seeing/needing help for long term, it still doesn't mean you need to pay upfront. Most medical billers will accept payments for up to a year. And if your share of the premium is $200 a month, and you have already paid some copays, you may be closer to your annual cap. Family plans are especially confusing- they may have an annual deductible of $14,000, or such, but each individual could have a $6000 cap. Your insurance plan rep won't want you to know about some of this and certainly isn't going to say 'don't worry' because the reps job is to keep costs low for the company. If all of a sudden, the rep was telling people they can get more care than they know about, upper mgmt might fire the rep. You need to get a COMPLETE copy of your plan- not just the 'summary' of benefits. Your ste may have someone in the health dept or attorney general office whose actual job is to help you. The company rep works for the company, not you.</p></blockquote><p></p>
[QUOTE="dmac1, post: 4842711, member: 60252"] You MUST have an annual out of pocket cap on deductibles that may be lower than you think. Your annual out of pocket under the AC is capped at about 10% of income. So even if your plan states a $6000 deductible, your personal cost may be lower even if you are not on an exchange plan. You may need to claim a credit on your taxes, or fill out some extra forms, but if you are only earning $40k for example, you may have options to continue care/therapy, and once you know you are going to be seeing/needing help for long term, it still doesn't mean you need to pay upfront. Most medical billers will accept payments for up to a year. And if your share of the premium is $200 a month, and you have already paid some copays, you may be closer to your annual cap. Family plans are especially confusing- they may have an annual deductible of $14,000, or such, but each individual could have a $6000 cap. Your insurance plan rep won't want you to know about some of this and certainly isn't going to say 'don't worry' because the reps job is to keep costs low for the company. If all of a sudden, the rep was telling people they can get more care than they know about, upper mgmt might fire the rep. You need to get a COMPLETE copy of your plan- not just the 'summary' of benefits. Your ste may have someone in the health dept or attorney general office whose actual job is to help you. The company rep works for the company, not you. [/QUOTE]
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