I suddenly have a bad stomach ache.

LucyGoosey81

Our plan has a 3K (I thought it was 2500, but was wrong) deductible and a 4K out of pocket max.  We have, of course, blown through the deductible this year, and even an extra 1K to get to the 4K max.

But I was wrong.  When I realized that the amount we owe is well over 4K, I did some research.  The 4K is ON TOP of the 3K.  I think I'm going to puke.

I'm so glad I am getting a raise because of my masters degree.  I need it.

carlab44

That doesn't make sense to me. If there is a $4K max out of pocket, that should include any deductibles, co-pays, etc. Otherwise it isn't truly $4K max out of your pocket since they are making you pay $4K plus another $3K. I'd maybe look into that a bit? Doesn't seem fair.

 

LucyGoosey81

I could...Here is what is online...

Family Participating Deductible Met	$3,000.00	$3,000.00	$0.00
Family Participating Out-of-Pocket	$1,209.10	$4,000.00	$2,790.90

 Doesn't that look like a separate thing to you?  I'm so confused.  I was so sure that the OOP max HAD to include the deductible.  (The first number is the amount paid YTD, 2nd is the limit YTD, and the 3rd is remaining).

carlab44

It does look like a separate thing, but to me it makes sense that they would list them separately. Saying here is how much of your deductible you have met, here is your max out of pocket, and here is how much you have left to reach your max out of pocket. So if your deductible is $3K and that has been met, I'd think the third line should be below $1K. I am CERTAINLY no expert on insurance though, so take all this with that caveat.