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Old 10-28-2017, 12:03 AM   #61
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Originally Posted by pb4uski View Post
Not sure... I had thought that aggregate deductibles were prohibited a few years ago but was surprised to see that there were still both aggregate and stacked deductibles for plans in my state for 2018.
ACA-compliant family plans must now have an embedded MOOP, not deductible.

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But this was changed with the 2016 Notice of Benefit and Payment Parameters. That regulation clarified that starting in 2016 (for plans that are not grandfathered or grandmothered), no individual can be required to pay more than the individual out-of-pocket maximum, even if the individual is enrolled in a family health insurance plan.

Under the new rules, no single member of a family can be required to pay more than $6,850 in out-of-pocket charges in 2016, regardless of whether the rest of the family has incurred any claims. This includes people enrolled in family HDHPs, and HHS has clarified that this does not conflict with HSA and HDHP requirements.

If you’re browsing plans in the exchange, in many states they only show family deductibles and OOPMs on the multi-plan comparison screen if you enter information for more than one family member. So you may need to look a little further to see what the individual OOPM is. In 2016, it won’t exceed $6,850, and in 2017, it won’t exceed $7,150.

But as long as you have an ACA-compliant health plan, you can rest assured that if a only one member of your family needs extensive medical care during the year, your out-of-pocket costs will be capped at no more than $6,850 in 2016, even if your plan has a family OOPM of $13,700.

Reference: https://www.healthinsurance.org/faqs...st-one-person/
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Old 10-28-2017, 08:53 AM   #62
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Join Date: Jun 2017
Location: Western NC
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Originally Posted by Senator View Post
It is a lot more money. It's more people. Adding an additional person, even if it's in the same family, probably costs 2x in medical care. A PPO would cost more, as you have more choices.
For 2017 on my DW's employer plan it was only $100/month to add unlimited 'children' (up to age 26 for post-secondary students) so we kept all our kids on her plan, even though the oldest already qualifies (and uses) Tricare.

But it would have been another $1000/month to add me, so I bought a cheaper ACA-compliant plan off the exchange.

Interestingly, her employer dropped the $5000 (family) deductible plan as employees eschewed that one for the plans with lower ($1000/$2000) deductibles, though those come with significantly higher monthly premiums.
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