Whats's your health insurance annual deductible, & annual out of pocket max?

GunsMadeAmericaFree

Golden Member
Jan 23, 2007
1,391
379
136
We just got a letter from United Healthcare, the health insurance that our family has had since January 1, when they switched over from Anthem. The letter said something about annual maximum in network deductible, so I went online to find some examples of that, to understand it better. I found this example:

Deductible vs out-of-pocket-max example​

Let’s say you have a health insurance plan with a deductible of $1,000 and an out-of-pocket maximum of $4,300.

So I looked down at our insurance, and I see that we have a family annual in network family deductible of $5,000. It also shows that we have a Maximum in network Out of Pocket Maximum of $6,850.
The letter also showed that as of March 31, we are about $4,000 of the way towards meeting the $5k annual deductible, and $6,850 out of pocket annual maximum.

WOW!!! These numbers are definitely higher than they were last year under Anthem, and they have really jumped up a LOT over the past 8 or 9 years. It was about 9 years ago when my wife's workplace took away the choice of
traditional health insurance, where you would just have insurance, and you would pay a copay, something like 10% each time you went in for medical treatment. They switched over to high deductible, which the first year had something like
$3,000 that we had to pay up front, maximum. It has grown every year.

Anyway, I found myself thinking how unlikely the example is, but then realized that I have absolutely no idea what typical numbers are for a family. Is the $1,000 annual deductible and $4,300 annual out of pocket max example
pretty common for a family, or is out situation more common?

All I know for sure is that we used to be able to put money into our IRA, but now that we pay the first $5K or more of health care costs out of pocket each year, we don't have much left to sock away for retirement. Not sure what folks are going to do if it keeps going this direction. Let's say, in 15 years - how will the typical family deal with having to pay the first $15,000 of heatl care costs up front out of pocket each year???
 
  • Like
Reactions: cerialiaa2

WilliamM2

Platinum Member
Jun 14, 2012
2,871
820
136
Max out of pocket of $6850 for the entire family? $5000 deductable for an entire family?

Hate to tell you this, but you have great insurance. The wife and I have $3500 deductable, and $6500 Max out of pocket EACH. Used to be HIGHER. I remember paying just over $10K for cervical fusion in 2010, that doesn't include all the other costs that year, prescriptions etc. Was over 12K easily.

Here's the ACA mandated max:
 
  • Wow
Reactions: Captante

nakedfrog

No Lifer
Apr 3, 2001
62,444
18,438
136
I have a $6k family deductible and $13.8k family out of pocket limit :confused_old:
If you have an HDHP you could be putting money into an HSA.
 

pete6032

Diamond Member
Dec 3, 2010
8,094
3,539
136
$2k OOP and $4.5k max but literally nothing is covered until $2k, not even regular physical.
 

IronWing

No Lifer
Jul 20, 2001
72,636
33,462
136
Deductible is $3,000 for self plus one plan but there is an employer premium pass through to an HSA that knocks the effective deductible down to $1,200. Out of pocket max is $10,000. We blow through the deductible every year thanks to corrupt U.S. patent laws.
 
  • Like
Reactions: Captante

Captante

Lifer
Oct 20, 2003
30,353
10,876
136
Deductible is $3,000 for self plus one plan but there is an employer premium pass through to an HSA that knocks the effective deductible down to $1,200. Out of pocket max is $10,000. We blow through the deductible every year thanks to corrupt U.S. patent laws.

Aside from going on Medicaid/Medicare that's about as good as it gets in terms of "affordable" health coverage for us plebs/worker-drones in our "great" and "free" country.

:rolleyes:
 

MtnMan

Diamond Member
Jul 27, 2004
9,388
8,766
136
My max out-of-pocket for doctors and hospitals is $226. I'm about 50K in hospital and doctor fees so far this year, and my out-of-pocket is $226.

Prescriptions are a different story :(
 

Gardener

Senior member
Nov 22, 1999
770
561
136
I dropped my insurance this year. My wife is 65 so qualifies for subsidized insurance (USA medicare) I'm 60, in good health, and would rather pay out of pocket (or delay healthcare). I refuse to pay $8200 a year for silver tier insurance with a 2k deductible, 8k out of pocket, and 7 month wait times for non-emergency procedures. I've done that. Now I am turning the table.

(corrected dollar amount and typo)
 
Last edited:

MrSquished

Lifer
Jan 14, 2013
26,067
24,394
136
I'm dropped my insurance this year. My wife is 65 so qualifies for subsidized insurance (USA medicare) I'm 60, in good health, and would rather pay out of pocket (or delay healthcare). I refuse to pay $7200 a year for silver tier insurance with a 2k deductible, 8k out of pocket, and 7 month wait times for non-emergency procedures. I've done that. Now I am turning the table.
Your wife benefits from some of the small aspects of socialism we have here.

Socialismmakesamericagreat
 

Exterous

Super Moderator
Jun 20, 2006
20,569
3,762
126
No deductible for in-network. $2k deductible per person for out of network. Max out of pocket is $3k per person per year. Only two real downsides to the plan - I have to get a referral from my Dr to see a specialist (which only last a year so I have to re-see my Dr for recurring referrals). And second - I now have unrealistically high expectations for health coverage and cost when perusing jobs and considering early retirement
 
Dec 10, 2005
28,366
13,245
136
I cover my spouse and myself through one my employer's options. Deductible is $3k, OOP max is $8k; they also throw $500/year into an HSA for us and we also contribute to it. Our yearly healthcare expenses are low: 1-2 maintenance meds filled via the plan's online pharmacy (which thanks to some IRS rules, allows pre-deductible cost sharing) and maybe 1-2 office visits/year outside of annual physicals, which are covered pre-deductible.

The other options we had available to us:
  • Move to a higher tier plan with more upfront cost-sharing: the additional premiums and loss of the HSA meant we would be spending more than we'd be getting in benefits
  • Have my spouse take her insurance through her medical school instead: the premium for that was absurd; it had tons of cost sharing upfront, but in aggregate, the cost was way more than the option we ended up selecting
 

brianmanahan

Lifer
Sep 2, 2006
24,613
6,003
136
And second - I now have unrealistically high expectations for health coverage and cost when perusing jobs and considering early retirement

ugh, same here. i used to almost never go to the doctor with bad insurance. but with good insurance i've gradually gotten used to going to the doctor if i feel like i need to.

and that would have to change in a big way unless i wait till like 60 to retire, after which i can get the work insurance for a few years till i hit medicare age