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basp

For a young, healthy person, is there any reason to spend beyond the basic "bronze" plan?

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I was young & healthy.

Then a doc wanted to put a pacemaker in me the next day. He was wondering why I was still alive.

The infected gall bladder and aortic flutter came with no warning too.

I personally agree with the sentiment and I've never regretted having too much insurance.

But in this case wouldn't that scenario likely hit the same out-of-pocket limit that's on the bronze, silver, or gold plans? Or do I not understand how that works?

Why is out-of-pocket even a concern? Health insurance should cover unlikely catastrophic issues costing 5-8 digits, leaving generally "young & healthy" patients to absorb lesser costs in exchange for practically no maintenance costs.

If the bronze/silver/gold plans cover the petty stuff (routine checkups) but hit the wall on something as moderate as a pacemaker (as contrasted with, say, open-heart surgery or cancer chemotherapy), then the plans are royally screwed up. Don't go implementing a health care plan just to find out what's in it.

I'm confused. How do they "hit the wall" if you won't have to pay more than the out-of-pocket limit of $6350 per year but they still have to cover you? Do I not understand what that number means?

You might only think you're healthy. You'll be the first to test out the claimed pre-existing conditions benefits of Obamacare.

Why would it be "claimed"?

Currently in most states - small group plans are already "guaranteed issue" - which means that you will get covered, regardless of pre-existing conditions.

We have insured hundreds of customers with pre-existing conditions under California's current guaranteed issue rules . These are the same rules that are going into effect nationwide for individuals.

I can only assume his skepticism is based on the assumption that either companies will find a way around it, through some legal loophole, or the government is not telling people the whole truth about the coverage guarantee. I hope he meant the former.

I meant either. It's all empty promises until someone legally backs us up on either end. Someone gets to be the first test case.

It's "claimed" because the stories of recission are real, and to be expected from an industry that simply makes more profits by cutting costs (due to the inelastic demands of sick people needing health care). This story [1] is from 2009, before passage of ACA/Obamacare.

[1] http://www.dailyfinance.com/2009/09/02/think-youve-got-healt...

The deductible might be an issue for some people. If you don't have a spare $5,000 then you might choose to pay more per month to decrease the risk you have to pay that amount all at once.

Also, make sure to factor in the cost of any prescription drugs you're on.

If you have hobbies that may result in injury you might upgrade.

It's a pretty straightforward tradeoff: lower premiums = higher cost of care. Bronze plans are not inferior, just priced differently.

If an employer is paying, it's tax deductible to the company and doesn't count as income to you.

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