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No, the deductible is much lower. This is the maximum I can spend out of pocket in a year. But most ACA ("Obamacare") plans have no maximum for our of network providers.


Actuallly... If it is an ACA plan, there has to be a MOOP.

https://obamacarefacts.com/health-insurance/out-of-pocket-ma...

Now keep in mind, as mentioned earlier, if you go to an out-of-network provider, and get billed for the balance of what that provider charges and your insurance won't cover, that is now between you and the provider because the insurance claim is technically complete.

This is why in some cases you may want to redline the financial responsibility statement and specify you will pay up to a set amount over what your insurer disburses. Technically, the provider can come back and grumble, but if you absolutely cannot afford to get nailed with a notorious "surprise" medical bill, that's a much more "good faith" way to approach the transaction.

It sucks... I know.




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