Just checked my new ACA rates

[progree]

35. And now..

>> I think now I would have to pay $12500, the max out of pocket? <<

Sounds about right for a family of 2 or more. [font color = red]ON Edit: That's not the amount you HAVE to pay out of pocket, its the MAXIMUM amount you could pay for all medical expenses in a year (not including the premiums, but including deductibles and copays)[/font]

>>I am not sure how the 70/30 copay and 6000 deductible works for something like an appendectomy.<<

All medical expenses up to $6,000 in a year, you pay. Kaching.

Then above that level, 30% of all costs.

I have no idea what an appendectomy costs, I suppose I can look it up in HealthCareBlueBook or somesuch (which are average rates)

But if some surgery costs say $20,000, and that is your only medical expense in a year, you'd pay:

$6000 deductible
$4200 (remaining $14,000 * 30% copay)
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$10,200 Total

[hr]
If you had $4000 in other medical expenses in a year, than that surgery above would cost you:

$2000 remainder of the $6,000 deductible
$5400 (remaining $18,000 * 30% copay) [font color = red]On Edit: I corrected this[/font]
----------------------------------------------
$7,400 Total (such a bargain. limited time only. Act now and save!)


That's only if you are in network. The hospital might be in network, your surgeon might be in network, but the anesthesiologist might not be -- you could end up paying his/her entire bill, though I think most insurance plans have maybe a 50 or 60% copay on out of network providers, not 100%. (ACA's out-of-pocket maximums don't apply to out-of-network providers)

By the way, I sympathize on your premium increase. Mine went up 31% from $419/mo to $553/mo. (I'm single). And my copay for most procedures went up from 10% to 15%. And I don't qualify for subsidies either.