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HDHP Max deductible question.

HDHP Max deductible question.

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Old Nov 14th 2016, 9:21 pm
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Default HDHP Max deductible question.

My health insurance has a 12k max out of pocket for out of network and 6k for in network. Does anyone else have a similar plan? Are the out of pockets combined to give a total of 18k max out of pocket?
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Old Nov 14th 2016, 9:36 pm
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Default Re: HDHP Max deductible question.

My understanding is that my in-network OoP is a subset of my out-of-network OoP.
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Old Nov 16th 2016, 2:03 pm
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Default Re: HDHP Max deductible question.

Originally Posted by mrken30
My health insurance has a 12k max out of pocket for out of network and 6k for in network. Does anyone else have a similar plan? Are the out of pockets combined to give a total of 18k max out of pocket?
Two things.

1. Deductible and OOP are two different things. The deductible is the amount that you fully cover before the insurance starts to cover most of the cost (though sometimes prescriptions and Dr. visits are separate to this). The OOP is the maximum total amount that you pay.

2. No, they are not added together. But to be honest, it shouldn't matter since you should always try to stay in network.
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Old Nov 16th 2016, 4:49 pm
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Default Re: HDHP Max deductible question.

Originally Posted by Owen778
Two things.

1. Deductible and OOP are two different things. The deductible is the amount that you fully cover before the insurance starts to cover most of the cost (though sometimes prescriptions and Dr. visits are separate to this). The OOP is the maximum total amount that you pay.

2. No, they are not added together. But to be honest, it shouldn't matter since you should always try to stay in network.
Finally got clarification, the 6k for in network counts towards the 12k out of network. Staying in network is fine unless I have to go out of State or country.

I have a pretty good plan I believe, the deductible for my plan is only $3k for in network and $6k for out of network
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Old Nov 16th 2016, 5:00 pm
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Default Re: HDHP Max deductible question.

Originally Posted by mrken30
Finally got clarification, the 6k for in network counts towards the 12k out of network. ....
OK, so same as mine, above.
..... I have a pretty good plan I believe, the deductible for my plan is only $3k for in network and $6k for out of network
How many years have you ever reached your deductible?
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Old Nov 16th 2016, 5:03 pm
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Default Re: HDHP Max deductible question.

Originally Posted by Pulaski
OK, so same as mine, above.
yes
Originally Posted by Pulaski
How many years have you ever reached your deductible?
Every year, so far since I have been on the plan. But historically, I don't think I would have hit it in previous years. Intensive care is very expensive.
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Old Nov 16th 2016, 5:16 pm
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Default Re: HDHP Max deductible question.

Originally Posted by mrken30
Finally got clarification, the 6k for in network counts towards the 12k out of network. Staying in network is fine unless I have to go out of State or country.

I have a pretty good plan I believe, the deductible for my plan is only $3k for in network and $6k for out of network
That's probably good, but it also depends on what premium you're paying.
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