Health Insurance
Property & Casualty
Additional Information
Privacy Policy
Employment
Legal & Disclaimer
How Much Is My Out of Pocket Amount?
Your out-of-pocket maximum is the most you’ll have to pay for covered services in a policy period (one year), each January 1st it starts over again, and that includes cost of medications too. After you reach this amount, your health insurance plan will pay 100% for covered benefits called “essential healthcare benefits”. Your out-of-pocket costs are NOT your health insurance premiums. Your monthly premiums are totally separate and are in addition to your medical costs like co-pays, deductibles, and out of pocket maximums.
How Much Do I Pay?
Each plan can have a lower out-of-pocket maximum, these numbers are the worst-case scenario. Check your plans “Summary of Benefits” for details.
2021 Out of Pocket Maximum
The maximum out-of-pocket limit for a health insurance plan for 2021 is $8,550 for an individual plan and $17,100 for a family plan.
2022 Out of Pocket Maximum
In 2022 it is $8,700 for an individual plan and $17,400 for a family plan.
2023 Out of Pocket Maximum
In 2023 it is $9,100 for an individual plan and $18,200 for a family plan.
Think of it like a game of baseball. Once you’ve paid all of your “deductible“, you are standing on 1st base. Now you’ll begin to move towards 2nd base – “Co-Insurance”. During this time, co-insurance is where you and the insurance company split the medical bills (co-insure), for example 70/30 or 80/20. Usually, the insurance company will pay the larger amount and you’ll pay the lesser amount.
Your next step is 3rd base or your “Out of Pocket Maximum”. Once you’ve met your “out of pocket maximum”, you are now done paying anything else. The insurance company will pick you up on 3rd base, and carry you to home plate (they are responsible for unlimited coverage after your out of pocket maximum).
Note: This is an annual accrual, meaning it starts January 1st and ends December 31st each year.
Getting Help with Nevada Insurance Enrollment
It is hard to budget for health expenses when you do not know what your cost-sharing responsibility will be. At Nevada Insurance Enrollment, our health insurance agents can help you review your policy or find reliable health coverage.
Recent Posts
Personal Auto Insurance vs. Commercial vs. Rideshare
Determining if you can use a personal auto insurance policy or that you should get a commercial auto insurance policy can be tricky. Sometimes you can buy a personal auto policy for business use and can be enough for some businesses. But if you are required to cover high liability coverage, have an unusual vehicle to insure, haul equipment, are a taxi or rideshare driver, you are probably going to need commercial auto insurance or special endorsements and coverages.
No Qualified Health Plans in 14 Nevada counties for 2018
The Division of Insurance (DOI) stated that Nevada’s insurance carriers have decided to only offer coverage to Clark, Washoe, and Nye counties beginning in 2018. Nevada’s Exchange actively exploring potential solutions and resources for consumers facing limited to no coverage options.
Car In Storage? Don’t Cancel Your Auto Insurance!
If you have a car that you are just storing, or if you’re planning to leave your car here in the U.S. while you leave the country, or if you just don’t drive the car and don’t want to pay for auto insurance, here are some tips to consider before doing so.
Search This Website
Most Popular Pages
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog
#5) Request a Quote
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
Taxable year 2012 for Businesses
Employers offering group insurance must report employees and employers portion of health care premiums on Box 1 of the W2’s.
What is a Summary of Benefits?
This is a 4 page, double sided (8 pages) at-a-glance view of how your health insurance plan works and how it compares to other plans. It contains coverage facts, and much more. It must follow a standardized format so all insurance companies’ insurance plan details are in the same place, making the comparison easier.
Health Insurance Carrier
Health Insurance Carrier: The insurance company you receive your health plan from.
Health Insurance Will Change With Obamacare
With the passing of the Health Care Reform law (Obamacare) in March of 2010, there are going to be changes in the way we use (and pay) for our Health Insurance.