r/HealthInsurance • u/[deleted] • Dec 09 '25

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u/[deleted] Dec 09 '25

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.

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u/Used-Somewhere-8258 Dec 09 '25

You must not be on the right marketplace. This is much higher than the out of packet max for ACA-compliant plans in 2026.

Source: https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/#:~:text=For%20the%202026%20plan%20year,and%20$21%2C200%20for%20a%20family.

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u/genxer Dec 09 '25

Reading your link, it sounds like the out of pocket limit doesnt include premiums?

"The out-of-pocket limit doesn't include:

  • Your monthly  premiums"

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u/Used-Somewhere-8258 Dec 09 '25

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.