Anonymous
Post 01/01/2025 19:13     Subject: What is your out of network deductible and do you hit it for your kid's services?
Anonymous wrote:
Anonymous wrote:Hdhps are intended for normal use to not hit the deductible. The deductible is there for emergencies. If youre hitting, honestly, a PPO is probably a better option.


Not sure about OP but I have a PPO and the out of network deductible is $8000 also. It’s the highest level option we can choose. They just really don’t want to pay for out of network care.


Deductible or out of pocket max? Extremely uncommong for a PPO to have that high of a deductible.
Anonymous
Post 01/01/2025 17:32     Subject: What is your out of network deductible and do you hit it for your kid's services?
My out of pocket max is $15k for out of network and $8k for in-network. Once I spend $3k (my deductible) my in network services are covered at 90/10 and out of network 60/40. I always hit the deductible but never out of pocket max for out of network.
Anonymous
Post 01/01/2025 17:28     Subject: What is your out of network deductible and do you hit it for your kid's services?
Anonymous wrote:Hdhps are intended for normal use to not hit the deductible. The deductible is there for emergencies. If youre hitting, honestly, a PPO is probably a better option.


Not sure about OP but I have a PPO and the out of network deductible is $8000 also. It’s the highest level option we can choose. They just really don’t want to pay for out of network care.
Anonymous
Post 01/01/2025 16:16     Subject: What is your out of network deductible and do you hit it for your kid's services?
Hdhps are intended for normal use to not hit the deductible. The deductible is there for emergencies. If youre hitting, honestly, a PPO is probably a better option.
Anonymous
Post 01/01/2025 14:53     Subject: What is your out of network deductible and do you hit it for your kid's services?
13k and yes
Anonymous
Post 01/01/2025 02:18     Subject: What is your out of network deductible and do you hit it for your kid's services?
What services are you getting Op and would it be easier/cheaper if you had a diagnosis?
Anonymous
Post 01/01/2025 00:46     Subject: What is your out of network deductible and do you hit it for your kid's services?
Anonymous wrote:Holy mackerel. What kind of health insurance plans are these with multi thousand dollar deductibles? These aren’t regular PPOs, right? Is it a high deductible plan of some kind?


I assume it's high because OP is asking for "out of network" which is what you have to file for any provider who doesn't take insurance. Unfortunately a lot of providers who are good with ND kids don't take any insurance, especially psychologists and psychiatrists.
Anonymous
Post 12/31/2024 21:34     Subject: Re:What is your out of network deductible and do you hit it for your kid's services?
About $4500. I just looked at my annual totals and I paid out of pocket $13k this year and had about $79k paid by insurance
Anonymous
Post 12/31/2024 21:33     Subject: What is your out of network deductible and do you hit it for your kid's services?
Holy mackerel. What kind of health insurance plans are these with multi thousand dollar deductibles? These aren’t regular PPOs, right? Is it a high deductible plan of some kind?
Anonymous
Post 12/31/2024 20:48     Subject: Re:What is your out of network deductible and do you hit it for your kid's services?
Out of network deductible is about $6,000 and costs for ND child reach this amount late Feb / early March.
Anonymous
Post 12/31/2024 20:44     Subject: What is your out of network deductible and do you hit it for your kid's services?
$300 for one person, $600 for the family. We hit it by the end of January. My DH can never switch jobs because we have such good insurance.
Anonymous
Post 12/31/2024 20:38     Subject: What is your out of network deductible and do you hit it for your kid's services?
$6000 and I never hit it. Just assume youre paying full price for everything.
Anonymous
Post 12/31/2024 19:03     Subject: What is your out of network deductible and do you hit it for your kid's services?
Anonymous wrote:My out of network deductible is like $8000. I think I will just have barely hit it for 2024.

So if I understand correctly, I won't get much money back from the insurance company.

Sort of bummed out about this. Am I misunderstanding something?

I'm college educated. Why is this so hard?


Do you have BCBS standard and wishing you'd switched in open season too? I was looking at same thing and same thought.
Anonymous
Post 12/31/2024 17:32     Subject: What is your out of network deductible and do you hit it for your kid's services?
We have similar and yeah we just hit it this year. Basically we treat it like we have that amount of guaranteed medical expenses each year, plus whatever goes over.
Anonymous
Post 12/31/2024 17:07     Subject: What is your out of network deductible and do you hit it for your kid's services?
My out of network deductible is like $8000. I think I will just have barely hit it for 2024.

So if I understand correctly, I won't get much money back from the insurance company.

Sort of bummed out about this. Am I misunderstanding something?

I'm college educated. Why is this so hard?