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Reply to "Help me understand out of pocket maximums"
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[quote=Anonymous][quote=Anonymous]In network out of pocket is still only at 80% of allowable charges and you eat that 20% as COINSURANCE with BCBS. In other words if something is charged at $100 in network and that is the allowable charge, $80 goes to the deductible and $20 is "co insurance". So your out of pocket maximum is not an actual maxiumum.[/quote] With BCBS, you don't even start paying coinsurance until you've reached your deductible. So if your deductible is $3000, you're paying 100% of that bill until you reach $3000. After that, coinsurance kicks in, and that 20% of the bill you're paying, goes toward your out of pocket max. No more deductible. So if your bill is $100, insurance covers $80, you pay $20, and that $20 of coinsurance counts against your out of pocket max. [/quote]
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