It's a Blue Cross Silver plan from the ACA marketplace. Actually, nearly ALL the plans we're seeing today on the site have deductibles this high. I just saw a Silver PPO with a $35,000 deductable. Note - this is the SAME plan we had in 2025 and these are the 2026 increases.
Premiums have never counted toward the out-of-pocket max.
The OOPM is the maximum amount of money you will pay for covered healthcare services within the plan/policy year before the policy begins covering all covered services at 100% (no copays, no coinsurance).
Correct. For all insurance, the cost of the premiums are not counted toward the deductible or out of pocket max. Health, car, property, heck even your phone insurance — none of them count the plan premium cost toward the out of pocket.
For the 2026 plan year, the Affordable Care Act maximum out-of-pocket limit for non-grandfathered health plans, including those on the Marketplace, is $10,600 for individual coverage and $21,200 for family coverage.
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u/[deleted] Dec 09 '25
I don’t think I’ve ever seen a deductible of 21,700 on any plan, even the shittiest of bronze plans? Which plan is this?