Out of Pocket Maximum ?

[Mike Siegal]

Hi Friends,

I have a PPO covering me for primary insurance with Anthem. My Max. Out of Pocket is 4k.

If i go to the hospital (for any reason) what kind of policies are there to cover my 'Max Out of Pocket?'

Are there plans that will cover this if i am admitted to a hospital?

Thanks for your Input...

 

[sshafran]

Hi Friends,

I have a PPO covering me for primary insurance with Anthem. My Max. Out of Pocket is 4k.

If i go to the hospital (for any reason) what kind of policies are there to cover my 'Max Out of Pocket?'

Are there plans that will cover this if i am admitted to a hospital?

Thanks for your Input...

What state? What age?

Hospital indemnity comes to mind as a possibility.

 

[somarco]

A HIP (hospital indemnity policy) MIGHT cover your OOP if charges incurred as an inpatient.

But what if you are never admitted? What will you do then?

 

[Yagents]

Nat Gen has a Plan Enhancer indemnity product that allows you to get a combination of benefits. AME is for accidents and covered if inpatient status results. Then, they have SIP plan, that stands for Sickness Inpatient, and covers you for inpatient stays due to Illness. I like the combo for this situation, and recommend it to my clients sometimes when appropriate. Haven't found any other reason for inpatient besides an accident and/or illness. You can also add on heart/stroke/cancer policy. (CHS).

4k OOP on group is a pretty low OOP, and a waste of money to buy a supplement indemnity plan in my opinion. Ever heard of being "over insured".

 

[Mike Siegal]

A HIP (hospital indemnity policy) MIGHT cover your OOP if charges incurred as an inpatient.

But what if you are never admitted? What will you do then?

It's insurance (in case). If I'm never admitted.… It's a loss. Just like my car insurance.… Large portion of my car insurance is collision.… I havent been in a wreck for so long I can't remember.

 

[Mike Siegal]

Nat Gen has a Plan Enhancer indemnity product that allows you to get a combination of benefits. AME is for accidents and covered if inpatient status results. Then, they have SIP plan, that stands for Sickness Inpatient, and covers you for inpatient stays due to Illness. I like the combo for this situation, and recommend it to my clients sometimes when appropriate. Haven't found any other reason for inpatient besides an accident and/or illness. You can also add on heart/stroke/cancer policy. (CHS).

4k OOP on group is a pretty low OOP, and a waste of money to buy a supplement indemnity plan in my opinion. Ever heard of being "over insured".

thanks Steve.… A friend of mine claims if she's admitted to the hospital for any reason, she get a check to cover whatever expenses. I have to give her a call and find out who the carrier is. (she could be confused too).

BTW...Why would you say the covering 4K out of pocket is a waste of money?

 

[LostDollar]

BTW...Why would you say the covering 4K out of pocket is a waste of money?

Caveat, not an agent.

It depends on a combination of your health, your risk tolerance and your ability to manage cash savings and plan for health expenses.

If you ask an insurance company to cover your risk of health expenditures down into levels where their actuaries tell them that there will be a large volume of claims, the insurance companies will have to charge a higher premium to cover their higher cash outlays.

For an example of this principle in action look at the premium difference between a Medicare Supplement Plan F, a Medicare Supplement Plan G and a Medicare Supplement Plan HDF from the same carrier. I am sure that some of the Plan F difference is just a "because we can get away with it" type of reasoning, but I suspect a significant portion of it will come from potential claims based actuarial science.

 

[LostDollar]

Hi Friends,

I have a PPO covering me for primary insurance with Anthem. My Max. Out of Pocket is 4k.

If i go to the hospital (for any reason) what kind of policies are there to cover my 'Max Out of Pocket?'

Are there plans that will cover this if i am admitted to a hospital?

Thanks for your Input...

Caveat, not an agent.

If you are reasonably healthy, you will, in my opinion, be better off getting your AZ friend to counsel you about HSA eligible health insurance and setting up an HSA account. (Don't tell him I sent you though.)

 

[Yagents]

Blah blah ......actuary.......blah blah..
HSA.......blah blah... F vs G...... blah blah.....non agent tool

 

[rousemark]

Hi Friends,

I have a PPO covering me for primary insurance with Anthem. My Max. Out of Pocket is 4k.

If i go to the hospital (for any reason) what kind of policies are there to cover my 'Max Out of Pocket?'

Are there plans that will cover this if i am admitted to a hospital?

Thanks for your Input...

You don't say what state you are in but one of the best for the money is Manhattan's Out Of Pocket Protection Plan. You can look at it on this page but the app won't work for you unless you are in TN.

ManhattanLife Direct