Medical Insurance- Lifetime Max

[bizlady]

We always thought we had really good insurance through my husbands union. We recently discovered however that there is a lifetime max of 300k per person. That seems really low to us. After that, catastrophic coverage kiscks in at just 15K per year. (this is not the deductible-but the max they would pay fopr a catastrophic event.)

This seems low to us. Assuming you are not in medicare yet, what is the lifetime max of your medical coverage?

 

[audreyh1]

$3M I think - or thereabouts. It was $1M when I started, but they increased it a few years ago.

Yeah, $300K lifetime max seems really low. Are you sure about that?

Audrey

 

[REWahoo]

I took a look at our two plans: DW (state high risk pool) has a $2M individual lifetime max and my plan has a $5M individual lifetime max.

 

[bbbamI]

Made me look too. There is no limit in Network and one million per person in Non Network.

 

[plex]

$5M for mine, I prefer my insurance to be only that, insurance in case something catastrophic happens (major disfigurement/lose a body part/cancer). $300k is very low, it won't cover most catastrophic situations (though not as ridiculous as the insurance my university offered...100k, and it costs 4x as much as what I have through BCBS).

 

[donheff]

Wait a week. If Obamacare gets passed lifetime maxes go away. It may take a while to phase in so don't get real sick right away

 

[ksr]

My lifetime max is $3M. I'd like to switch to a higher-deductible plan, but everything I've looked at seems to have a lifetime max of just $1M, which I'm afraid is too low.

I've never seen a plan with a lifetime max lower than $1M. 300K sounds very low. I'd double-check that.

 

[Walt34]

Ours is $2M lifetime max. I'm pretty sure we're not even close to that.

 

[bizlady]

Unfortunately, it is indeed 300K. Great coverage otherwise, but this was a big discovery and surprise for us. Husband just had a 2nd pneumorthorax in a month at 54, and had to have a surgery this week. And this was the retirement plan that we were counting on for insurance after retirement at 55. A big overlook on our end as we planned.

 

[fisherman]

Ours is 5M each with a $7K deductible as this is how we like to use insurance. Here is hoping we never need that amount and if we do that they would actually pay.

 

[cardude]

Just looked ours up because I didn't know. $5M is lifetime max.

 

[ERD50]

Wait a week. If Obamacare gets passed lifetime maxes go away. It may take a while to phase in so don't get real sick right away

Another conundrum! If Obamacare passes, I probable will get 'sick' right away!

- ERD50

 

[FIRE'd@51]

Wait a week. If Obamacare gets passed lifetime maxes go away.

They may go away, but at the expense of a higher premium, all else equal, just like with any other insurance. I, for one, would be willing to pay that extra premium so no one (myself included) would have to face a lifetime cap. The same is true for deductibles or caps on annual out-of-pocket expenses (although these I'm willing to self-insure for in exchange for a lower premium). They have to raise the premium, all else equal. I just wish Obama would be honest about these things rather than implying people can get them for nothing.

 

[donheff]

They may go away, but at the expense of a higher premium, all else equal, just like with any other insurance.... I just wish Obama would be honest about these things rather than implying people can get them for nothing.

Interesting how we all hear things differently. I specifically heard Obama acknowledge that some people will experience higher premiums but would be getting more benefits.

 

[FIRE'd@51]

Interesting how we all hear things differently. I specifically heard Obama acknowledge that some people will experience higher premiums but would be getting more benefits.

"Some people"? Correct me if I'm wrong, but I thought the removal of lifetime caps would eventually apply to all policies. Doesn't that affect all people?

 

[donheff]

"Some people"? Correct me if I'm wrong, but I thought the removal of lifetime caps would eventually apply to all policies. Doesn't that affect all people?

A lot of company policies have no lifetime caps. My government policy doesn't. The vast bulk of these huge cost situations are among the elderly who have Medicare, also without a lifetime cap. The reality is that lifetime caps for younger people is just a cost saving tweak the insurers apply. It doesn't matter much in the broad scheme of things but it is a disaster if you are one of the statistical outliers who get a bad toss of the dice.