How exactly do out of pocket maximums work?
I’ve seen some health plans where the deductible is say, $2000, and the the out of pocket maximum is say, $2000. Does that basically mean that there is no deductible (not that the deductible is $0 – but that the health plan either covers all or nothing)?
Also, I’d always assumed that a health insurance plan would cover 100% of your (covered) medical expenses after you reached your out of pocket maximum but, last month, I hit the out of pocket maximum for my 2021 health insurance plan and, last week, I had to have a minor procedure done and ended up having to pay a portion of the bill. So, if I had to pay for any medical expenses after reaching my out-of-pocket max, I’d assume that the procedure wasn’t covered by my medical insurance but the fact that my insurance is indeed paying for some of the procedure means it is covered and, since I’ve already reached my out of pocket max, shouldn’t they be paying 100%? Is there some out-of-pocket max loophole I don’t know about (which wouldn’t surprise me because I know extremely little about medical insurance) or should I be giving my insurance company a call?
Thanks
submitted by /u/Virus4762
[link] [comments]How exactly do out of pocket maximums work? I’ve seen some health plans where the deductible is say, $2000, and the the out of pocket maximum is say, $2000. Does that basically mean that there is no deductible (not that the deductible is $0 – but that the health plan either covers all or nothing)? Also, I’d always assumed that a health insurance plan would cover 100% of your (covered) medical expenses after you reached your out of pocket maximum but, last month, I hit the out of pocket maximum for my 2021 health insurance plan and, last week, I had to have a minor procedure done and ended up having to pay a portion of the bill. So, if I had to pay for any medical expenses after reaching my out-of-pocket max, I’d assume that the procedure wasn’t covered by my medical insurance but the fact that my insurance is indeed paying for some of the procedure means it is covered and, since I’ve already reached my out of pocket max, shouldn’t they be paying 100%? Is there some out-of-pocket max loophole I don’t know about (which wouldn’t surprise me because I know extremely little about medical insurance) or should I be giving my insurance company a call? Thanks submitted by /u/Virus4762 [link] [comments]Read Morer/HealthInsurance