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View Diary: ACA: I enrolled! (125 comments)

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  •  So some questions for you (1+ / 0-)
    Recommended by:
    high uintas

    1. Do we still continue to pay the co-pays after the out-of-pocket max (oop-max) cap is exceeded?
    2. Do co-pays count as part of the deductibles?

    If 1 is no and 2 is yes, then my total obligation would be premiums plus oop-max if I had a catastrophe. How do you figure it?

    •  The quick answer (7+ / 0-)

      The quick answer ...

      Under the law, the maximum amount a consumer with single coverage will pay out-of-pocket in 2014 will generally be $6,350 while a family could pay up to $12,700. Those totals include copayments and deductibles, but not premiums, and they apply only to plans that are not grandfathered under the law.
      However, there are some exceptions in 2014.  For more detailed answer, see here.

      ______________
      Love one another

      by davehouck on Thu Oct 17, 2013 at 09:51:06 AM PDT

      [ Parent ]

    •  This is a worthy question .. (1+ / 0-)
      Recommended by:
      Larsstephens

      ..because I reached my out of pocket max last year due to multiple surgeries, but I still had to pay that co pay (pay at the reception desk of the doctor's office before you even see your doctor.)  I called the insurance and they said, basically, "That doesn't mean what it says literally."  The website simply had said "out of pocket maximum."  Yeah, right.  Not to mention that the Rx coverage was with a different insurance company.

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