Did you expect to have a reduced out-of-pocket maximum (worst case cap on medical expenses) next year?

On July 12, 2013, the Obama Administration released that the out-of-pocket maximum caps for many working Americans has been postponed. An out-of-pocket maximum is the worst case that an individual or family would pay in a year for all of their combined medical expenses. For example if someone went into the hospital for a month an individual would hit their worst case of say $6,000 before all expenses additional expenses would be paid at 100% by the insurance carrier.

Valerie Jarrett, Mr. Obama’s senior advisor noted, “Federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs. In many cases, the companies have separate computer systems that cannot communicate with one another.”

It was surprising to see how a “senior administration official” said that “we had to balance the interests of consumers with the concerns of health plan sponsors and carriers and asked for more time to comply.” There is absolutely no reason that consumers want to have out-of-pocket maximums increased if decisions are being made in their best interest. Again the government is showing they are moving too fast with certain regulations that cannot be enforced. It seems like a delay on the individual mandate (the requirement for all individuals to purchase medical insurance) is the next item up to be postponed.

Below is a great video Kaiser has developed to explain Health Care Reform in layman terms. Individuals and businesses can get a great idea of how Obamacare is really going to affect them. As many of you already know unless you are between 100-400% of the federal poverty level (FPL) or an annual income of less than $44,680 as an individual or $92,200 as a family you will not receive any medical premium assistance.

Contact us for a free consultation or call us at 650-367-0259 if you would like any assistance finding an affordable medical plan with a low out-of-pocket maximum until these regulations are upheld.