Earlier quoted context omitted.
>Routine newborn vaccines are around $900 per visit even with partial insurance coverage. Per ACA, all routine newborn care (including vaccines and routine blood draw) is 100% paid by insurance company. The specifics are all listed in the links below. https://www.healthcare.gov/preventive-care-children/ https://www.healthcare.gov/coverage/preventive-care-benefits... >Not to mention any unforeseen hospital visits that…
Unfortunately that’s not exactly how it works. We don’t have a marketplace plan, so our insurance has no responsibility to pay for anything really. The link you shared says this. “All Marketplace health plans and many other plans must cover the following list of preventive services for children without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.” Maximum out o…
>Maximum out of pocket only kicks in once you’ve hit the deductible on 2+ family members, at least for our plan. So for us, the max is $20k.
Out of pocket maximum has nothing to do with deductible. Copays/coinsurance “kick in” after deductibles are reached.
If you had purchased ACA complaint health insurance, then OOP max is simply OOP max, a single number that once you reach, you do not pay further for in network services (and now for out of network emergency services also).
Edit: note that a “Marketplace” (or ACA complaint) plan explicitly transfers wealth from young and/or healthy to old and/or unhealthy, where healthy and unhealthy mean “does not need healthcare” and “needs healthcare”. So by choosing to go with a non Marketplace plan, they are placing their bets on not needing healthcare…which is probably not a winning bet for people birthing and raising young children.