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@ilovejesus90 What does the EOB say you owe? Was the doctor in or out of network. If they're INN, preventive care should be no cost to you.

@dork87 Dual coverage is pretty useless these days unless one is free or offers a benefit the other does not. It's definitely pointless if either plan is Kaiser, and generally pointless if the primary would be a PPO and the secondary an HMO. The premiums you'd pay to be double covered aren't...

@needmorejesus That doesn't mean the plan doesn't have prescription benefits lmao. They are subject to the deductible, which is entirely normal. Them having to pay out of pocket doesn't mean it's not covered. Covered =/= paid for. Covered means eligible to be billed to the plan, and subject to...

@dork87 With an SEP, you can only generally add or remove people to your existing selections. You wouldn't generally be able to change what plan you're on or add people for whom the SEP does not apply. But sometimes I see it happen so it is something to confirm.

@needmorejesus Why do you think there is no prescription coverage? Prescription benefits are an essential health benefit and on HDHP plans, the Rx is commonly tied into major medical. If it's combined, you won't see it separated out into tiers of coverage like some other plans may state, as...

@dork87 The SEP is for the child, if you're not already enrolled in each other's plans, you may not be able to do so now.

@ebbnflow It should be in the spd or eoc documents. Do you have a benefits dept at work?

@ebbnflow Is bariatric surgery a covered benefit with your employer plan?

@needmorejesus Uhh, you will not find a marketplace plan with a $1200 deductible for $47/paycheck or ~$101 per month. If they can't afford the $1200 deductible why would you recommend a marketplace plan that will be more expensive with an even higher deductible? I'm not clear why that would...

@jwesley I'd not heard of one called ICHRA, I don't deal too often on the business side of things, but it looks like that's QSEHRA's descendant! I'll read into it, thanks!!

@jwesley I wonder if they're a smaller company and or a tech based company, that tends to be more where I see that on the fewer occasion that I do see it. It's also just somewhat messy to set up if you're doing some sort of HRA or QSEHRA compared to just payroll deductions. Agreed. Unfortunately.

@jwesley Deductible isn't the only consideration for an HSA. There has to be zero first dollar coverage and OP can't be on any other disqualifying type of health plan. The maximum out of pocket allowed on an HDHP eligible HSA is capped at $7000 for 2021. The plan does not appear HSA eligible as...

@lindalee1456 The sole factors affecting aca compliant healthcare premiums are age, income, zipcode, tobacco use, and metal tier you pick. With an employer, those first three tend to not matter if they have a large enough risk pool. So no.

@believerben You're welcome! Not a lot of people realize it's more than just deductible. If you want to learn more you can review IRS Publication 969! :) I've never understood why a company would offer a plan like the Silver here and not just make it HSA eligible... seems like it'd be a win-win.

@believerben The HDHP eligible HSA plans have a maximum out of pocket capped at $6900 for 2020 and $7000 for 2021. As the silver plan has an OOP of $7500, it does not appear HSA eligible. Deductible alone is not the only metric making a plan HSA eligible (deductible min of $1400/$2800 individual...

@happilyretired Since you have workplace coverage that is affordable, you won't qualify for the APTC. You're exceedingly unlikely to find a marketplace plan with similar coverages for only $450/mo unsubsidized. You don't need to ask your providers if they take UHC, you need to ask UHC if they...

@resjudicata 🤣🤣💯

@doctoraines https://nystateofhealth.ny.gov/

@latin2112 I understand, my point is no single individual can spend more than $8550, even if the family OOP is $11k. At that point, you must have individual embedded OOP max values. None of us here your doctor and can't predict what care your kid needs, if you're looking for that kind of...

@shivang You don't have anything to fight. You clearly don't have a working foundation for insurance and I don't blame you for that, but you haven't been wronged here. You owe the $1k. That's the contracted negotiated rate of the service. You pay per your plan benefits which are your...