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Resource Guide
On Private Health Insurance Coverage & The Health Insurance Marketplace
FAQs tagged with “Out-of-Pocket Costs”
- I evacuated from my area because of a natural disaster, and none of my doctors are close by. What are my options?
- I heard not all plans have to meet all rules. How do I know if my plan has to comply?
- I need a hip replacement and when I asked my insurer about coverage, I was told that my plan uses reference pricing. What is that?
- I thought there was a cap on out-of-pocket costs but my prescription drug benefit requires me to pay co-pays even after I’ve met the out-of-pocket limit for other medical benefits. Is that allowed?
- I thought there was an annual cap on my out-of-pocket costs, but I’m getting billed for something that puts me well above the limit. How can that be?
- I was in the hospital when my coverage changed from my old plan to my new, Marketplace plan. My provider during that episode of treatment is no longer in my plan’s network and I’m worried I’ll face higher cost-sharing as a result. Is this allowed?
- I’m seeing some gold plans with cheaper premiums than silver plans. Aren’t gold plans supposed to be more expensive?
- When I went to the pharmacy to get my birth control, I had a co-pay. I thought all contraceptive coverage had to be free?