Ours is $4500 a month for 2 middle aged parents and 3 teens. We don’t have a deductible in network and I can’t remember what it is out of network because our network is really good, even for our kid in college out of state. It’s carefirst point of service. There’s a copay for everything except annual eel visits, which I think is $20 primary, $30 specialist $50 ro urgent care, and $100 for Er. That’s the price after the 10% increase for this year.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you're a family of 4 in Northern Virginia (2 middle age adults/2 preteens) - how much are you paying for health insurance if you're self-employed / not employer sponsored? What are your deductibles & copays?

$28,000 + $10,000 deductible= $38,000 out of pocket per year. 100% coverage once that is met

Do you hit this deductible each year? IME not a lot goes to the deductible so you’d end up paying a lot more. If I didn’t have a chronic disease, I’d probably buy the cheapest plan out there and just self pay. Most of my doctors don’t take insurance anyway.

DP: to get an EPO in my state (there are no PPO and I'm not switching to an HMO where my doctors are not in network, not happening). The difference between Bronze and Silver is only $150/month/person in our mid 50s. Even so, the Silver is a better deal (one of us visits doctors frequently and has had multiple strange/new health issues in past year that will continue to require care). But it's $3200/monht for just medical (no dental/vision) and dedcubitle will be $7K/14K. So I'm estimating we will pay $4.5K-5K/month for it all by end of 2026.

As you are budgeting, please remember that you deductible and OOP reset January 1. If, God forbid, something major happens (like cancer) in December, you could very well need double your deductible and OOP as a reserve.

Anonymous wrote:$3800/month. I am 46, DW 41. We have 2 kids 14 and 12.

We are thinking about selling our business and getting a W2 job.

Incredible. This reminds me of my friend who told me he makes $300k/year, but then when he told me about this health plan/benefits/cost and his annual leave policy that $300k came with a huge asterisks.

$3800/month. I am 46, DW 41. We have 2 kids 14 and 12.

We are thinking about selling our business and getting a W2 job.

Single mom paying $1300/m for myself and two kids. $28k max OOP, bad coverage, none of our preferred doctors are in network

Anonymous wrote:

Anonymous wrote:You’d almost think the Affordable Care Act wasn’t affordable.

You'd almost think the Republicans have been dismantling the Affordable Care Act piece by piece since the day it was passed.

But still somehow have no plan of their own.

Anonymous wrote:

Anonymous wrote:If you're a family of 4 in Northern Virginia (2 middle age adults/2 preteens) - how much are you paying for health insurance if you're self-employed / not employer sponsored? What are your deductibles & copays?

$28,000 + $10,000 deductible= $38,000 out of pocket per year. 100% coverage once that is met

Do you hit this deductible each year? IME not a lot goes to the deductible so you’d end up paying a lot more. If I didn’t have a chronic disease, I’d probably buy the cheapest plan out there and just self pay. Most of my doctors don’t take insurance anyway.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You’d almost think the Affordable Care Act wasn’t affordable.

Wasn't meant to be. It was a payback for big corporate insurance companies for their lobbying efforts. Was designed to drive up prices.

The only solution is to deregulate insurance scam and allow more competition and a free market.

Also support more "cash-only" doctors and clinics, who are required to post prices for everything online and at their business locations so patients know in advance what everything costs, with no hidden fees.

The ACA has become a de facto high risk pool because the health insurance mandate was gotten rid of. It’s really too bad.

"nooo we don't want to insure people who aren't perfectly healthy!"

Big Insurance chimes in.

That’s not what I said. Insurance companies under the ACA are required to insure anyone, but when everyone who buys insurance has a pre-existing condition (some of which are expensive to treat), the insurance becomes more expensive too because there aren’t buyers who pay more into the system than they get out.

$180 a month for a child with $6300 deductible and $680 for a parent with $9500 deductible in DC.
I have no idea what is and isn't deducted or covered. We both have been to doctor once this year and never got a bill.
I'm dropping my insurance for 2026 and paying the fine. I'm never sick and going to EU is an option.

Family of 4. Aetna PPO. This is via DH’s work BUT he is a partner/employer/owner so it is big subsidized and we are full pay. We need the PPO because I have a congenital physical disability that requires a lot of specialists and frequent medical care.

I am a contractor so don’t get benefits at my job, otherwise I would consider switching to that employer’s plan.

Monthly for our family we pay $3,600, we have a $625 in network deductible and then a $2,500 out of network deductible (both of which we meet each year). I have found our plan to be very good at covering costs but it is very expensive overall to have but the medical bills would be catastrophic for us if I went without insurance.

As for going with a nationalized system like in France or UK or Canada, I have a wide network of friends with my condition and we all swap information on specialists and around the world. I also have sought medical care in some of those countries in the past (Canada and France). It has been my experience that complex needs are poorly met under those systems, wait times are extremely long for routine issues and if your case is complicated you can forget getting specialized care (unless you’re a child). I once was sent home to die because the French doctors thought I was just too hard of a case to figure out. So the grass isn’t always greener.

All these super-hugh deductible plans (usually bronze) are simply catastrophic plans - great if you end up with cancer, horrible if you/your family members needs an MRI for an ACL injury for example.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You’d almost think the Affordable Care Act wasn’t affordable.

You'd almost think the Republicans have been dismantling the Affordable Care Act piece by piece since the day it was passed.

Yep. Even though it's basically a Republican plan they hate it for some reason.

It’s because Dems have trying to use it as a single payor backdoor the whole time.

I really wish that was true, but it’s not.

$20k for 2 business owners.

Anonymous wrote:

Anonymous wrote:If you're a family of 4 in Northern Virginia (2 middle age adults/2 preteens) - how much are you paying for health insurance if you're self-employed / not employer sponsored? What are your deductibles & copays?

$28,000 + $10,000 deductible= $38,000 out of pocket per year. 100% coverage once that is met

That's pretty reasonable. $9,500 per person for 100% coverage.