Every time that I think I have a good grasp on how health insurance works, I find that I don't. After GRS went fishing for comments with their "Ask the Reader" post yesterday, I looked into my own health insurance and how it's actually been covering me so far this year.
I am an independent contractor, and purchased a shiny gold Obamacare plan this year because I'm pregnant. The deductible is $1000, and the Individual Out of Pocket Maximum is $4500. The insurance pays 20% for in-network services.
So far this year I've been responsible for about $400 total of my health expenses, with Premera picking up the other $1600 for ultrasounds, blood work, etc. meaning that I'm paying 20% of what they allow me to be charged. When I look at my account online, it shows that this expense has been counted towards my out of pocket maximum, but not against my deductible? I also looked at my son's account. He's had a well-baby check up which was 100% covered and a prescription that cost us $10. The $10 is being counted towards his OOP Max, but also not towards his deductible. So I'm confused about what counts towards the deductible?
My mom is a doctor, and my dad is a right wing nut. He's done a lot of complaining this year that they're going to go broke because no one is going to the doctor anymore because their OOPs are so high that they can't afford it, and when I tried to Google an answer to my question, I found a lot of posts about how you pay for 100% of your health expenses until you hit your deductible, but clearly that doesn't seem to be the case for me. I pay only my 20% portion, and presumably if/when I hit the OOP Max, I won't pay anything...right? And what happens when/if I hit my deductible?
Thanks in advance for helping me figure this out!