No. of Recommendations: 2
The tricky part is if you retire before 65 and have an income high enough that it exceeds the ACA subsidy thresholds. In that case, your maximum out of pocket insurance costs are capped at $18,900 or 8.5% of your income (IIRC, any clarifications welcome). Which is a lot to be sure.kff.org - Health policy the affordable care actPremiums are capped at 8.5% of household income, right now.
healthcare.gov - Out of pocket maximum limitThe most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.
The out-of-pocket limit doesn't include:
Your monthly premiums
Anything you spend for services your plan doesn't cover
Out-of-network care and services
Costs above the allowed amount for a service that a provider may charge
The out-of-pocket limit for Marketplace plans varies, but can’t go over a set amount each year.
For the 2024 plan year: The out-of-pocket limit for a Marketplace plan can’t be more than $9,450 for an individual and $18,900 for a family.Our bronze plan will cost us $28,780 this year, with an additional maximum OOP of $18,900 for in-network services.
Go out of network (which we do for some things) and it costs more.
