Forum Discussion
Stephen_W
Dec 23, 2013Explorer
I was just looking thru the healthcare.gov site (Florida)and was surprised (vs the promises) at the lack of real early dollar coverage provided by the lower tier plans. Most of them required the full $6,250.00 individual deductible to satisfied before covering any part of a Dr. visit, prescription, hospital, ER, etc., then the copay would be 40% for Bronze and 30% for Silver. I read the detailed summary pages and think I am right about that, + they were all EPO's or HMO's. So, it seems not much help for the ones that can only afford these lower tier plans until their out-of pocket expenses reach the deductible level. Am I not understanding this correctly? It looks like even a small medical event could really hurt someone with these plans. The Bronze plan would pay $2,250.00 on a $10,000 bill: $10,000 - 6,250.00 deductible = $3,750.00 x 60% (Bronze coverage) = $2,250.00 (22.5% of a $10,000 bill). The success of this plan is dependent on getting young people to enroll and I suspect most of them don't have the deep pockets to easily handle having the plan pay only 22.5% of the first $10,000.00. The higher tier plans do have much better coverage. Scary stuff.
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