I appreciate anyone who answers. I think I understand how this works, but would like to see if there is something I have not thought of or don't understand correctly. I think there is a 50% chance I will need surgery next year. Google says the procedure is minimally invasive and can cost between 6000-25,000 and can either be out patient or require one night stay. Other than that I am healthy, on one low cost prescription and don't go to the Dr. very often.
I am assuming that premiums never count towards the deductible or out of pocket max.
Plan A is free. It has a 7500 deductible and 9400.00 OOPM. Surgery is covered at 50% co-insurance. If the surgery above cost 25,000 I would play the first 7500.00, the the plan pays 50% for the next 19,000 at which time they plan pays the balance. Total cost for me is 9400.00.
Plan B is 526.00 a month (6312.00 a year) with 0 deductible and 9400.00 OOPM. If the surgery above cost 25,000 I would pay 0 and then 50% for outpatient so I would pay half of the 25,000 (12,500) but I'd reach my OOPM before that so I'd pay 9400.00+I'd also pay 6312.00 a year for the premiums. Total cost of 15,712.
It just seems like Plan B will only cost me 6312.00 more a year and not cover more.
There is another plan with 0 deductible, 5500 OOPM and 30% coinsurance (hospital stay) and a 200.00 co pay for outpatient. That plan is 591.46 a month so 7092 per year with an OOPM of 5500.
Am I thinking of all this is the right way?
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