Which is more important between the deductible and the out of pocket maximum? In the opinion of Compare Health Insurance the out of pocket maximum gets the nod. Let's take an example of two different ppo plans.
One plan has a $1,000 deductible and a $8,000 out of pocket maximum. Another plan has a $2,500 deductible and a $5,000 out of pocket maximum. Assume the same outpatient and inpatient copay percentage of 20% and same monthly premium.
Use a $50,000 emergency hospital bill. The $1,000 deductible plan would meet its out of pocket amount of $8,000. The cost would be $1,000 plus the out of pocket maximum of $8,000 for a total of $9,000. The $2,500 deductible plan would also meet the deductible and the out of pocket amount of $5,000 for a total of $7,500 out of pocket.
Nobody knows what the future holds regarding potential medical expenses. Our only point is to pay close attention to the out of pocket maximums and even more importantly to the number of members subjected to the out of pocket maximum.
We recommend focusing on the most important aspects of health insurance such as an affordable monthly premium and inpatient and outpatient deductibles plus out of pocket maximums. When comparing these important aspects of an overall health plans vs. receiving additional office visits or prescription drug coverage then we think the answer is obvious unless the individual has specific day to day needs outside of major medical coverage.
Health Carriers will tend to incentivize the purchaser of the plan to receive less overall benefits for a lower premium since it costs less in administrative and processing costs. Most of the time it makes sense to get less extensive benefits for a lower monthly premium.
Health insurance can be reviewed and purchased by clicking on the links which will direct you to a comprehensive quote and application system. We hope you enjoy the site. We offer only the best in San Diego medical health insurance for both individuals and businesses.
Please feel free to contact us toll free at 888-504-6171 or local at 858-271-8100.
