I'm confused about how to figure out whether to get a 0% co-insurance PPO, or a 20% co-insurance PPO.
(Below is in-network only, for simplicity. I'm looking a subsidized silver PPO plans.)
The 0% co-ins plan has deductible/OOPmax of 1500/1500. The 20% co-ins plan has a deductible/OOPmax of 500/1500.
So am I correct in assuming that, if I choose the 20% co-ins plan (which has a higher premium) I am gambling that, after a 500 deductible, my medical expenses will not exceed 5000? After that point, my OOP is 1500, so I"m on the same footing as if I had the 0% co-ins plan?
Next question: reading the fine print of BCBS-TX, it states that co-pays do not count toward deductibles. But do they count toward the OOPmax? The fine print says that premiums and balance-billed charges do not count toward OOPmax, but there is no montion of co-pays.
I also have to choose between a multi-state plan and a non-multistate plan. The multistate plan has lower premiums than the non-multistate plan; the co-pays are higher. The networks are the same. It is a toss-up?
(Below is in-network only, for simplicity. I'm looking a subsidized silver PPO plans.)
The 0% co-ins plan has deductible/OOPmax of 1500/1500. The 20% co-ins plan has a deductible/OOPmax of 500/1500.
So am I correct in assuming that, if I choose the 20% co-ins plan (which has a higher premium) I am gambling that, after a 500 deductible, my medical expenses will not exceed 5000? After that point, my OOP is 1500, so I"m on the same footing as if I had the 0% co-ins plan?
Next question: reading the fine print of BCBS-TX, it states that co-pays do not count toward deductibles. But do they count toward the OOPmax? The fine print says that premiums and balance-billed charges do not count toward OOPmax, but there is no montion of co-pays.
I also have to choose between a multi-state plan and a non-multistate plan. The multistate plan has lower premiums than the non-multistate plan; the co-pays are higher. The networks are the same. It is a toss-up?