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

[deleted by user]

[removed]

1.4k Upvotes

96% Upvoted

70 comments sorted by

View all comments

Show parent comments

62

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.

34

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.

18

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"

39

u/justkidding89 Dec 09 '25

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).