Andrew Sprung writes about the ACA. I read him quite often as his posts are expert analysis of the ACA and healthcare. Mostly recently this commentary was posted by Andrew on the benefits of getting a Bronze plan as opposed to a Gold plan if facing large out of pocket expenses (premiums + deductibles).
“XPOSTFACTOID” Mostly about the ACA: Obamacare to Trumpcare.
In discussion of the ACA marketplace (and health insurance generally), deductibles are often used as a stand-in for out-of-pocket costs. Now here cometh David Anderson to remind us that a plan’s maximum out-of-pocket cost (MOOP) can be just as important — and that the MOOP often does not particularly correspond to metal level.
The highest allowable MOOP at all metal levels is $8,150 (a travesty by international rich country standards). Here is David’s mapping of the range of MOOP for gold plans in HealthCare.gov states. Dark green is $2,500 MOOP; dark red is $8,150.
As David points out, bronze plans will be a better deal for anyone who knows they’ll hit the out-of-pocket max. As he’s pointed out elsewhere (and in passing here), it takes a lot more spending to hit the high max in a gold plan — say, $30,000 — than in a bronze plan. That’s because once you meet your deductible (likely to be relatively low in a gold plan with high MOOP), a high percentage of ensuing costs will be covered in a gold plan until the MOOP is reached, at which point coverage goes to 100% for ensuing costs (if you stay in network).