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Babhadfad12 t1_jaatlnw wrote

Reply to comment by Evening_Attention_45 in No Mental Health Coverage with Marketplace by Evening_Attention_45

What you are writing makes no sense. If the insurer paid before the deductible was met, then it would not be a deductible.

What you want is an insurance plan with no deductible.

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The_Gandhi t1_jaay269 wrote

Insurance plans generally have exceptions where deductibles aren't applicable.. it would make medical insurance useless for most people if they had to pay out of pocket till the deductible was reached for everything.

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Babhadfad12 t1_jaayhve wrote

I have never heard of that. In health insurance, the only things covered before deductible I have seen are preventative visits mandated by law.

https://www.healthcare.gov/glossary/deductible

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The_Gandhi t1_jaayx4q wrote

I have been to PT and only paid a copay so I know that exists. Not sure which other kinds of treatment are covered typically. Your plan benefits guide will mention which items fall under the deductible and which are exempt.

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Evening_Attention_45 OP t1_jab8uj1 wrote

The link you posted literally states exactly what I'm saying.

This is taken directly from the link:

Deductible

"The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself."

I would need to pay $2,000 out of pocket before any of the insurance plan pays.

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Babhadfad12 t1_jabas86 wrote

…right, because that is what a deductible is. My original response was to this statement:

> I figured therapy would just be a copay and that you wouldn't need to pay the entire deductible before insurance kicking in.

I explained why this is not a thing.

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Evening_Attention_45 OP t1_jab8j9y wrote

Literally every insurance plan on Marketplace has a deductible. Most insurances have a deductible. I'm not sure how you haven't experienced this or at the very least know that a deductible is extremely common.

Most of the plans available via Marketplace for NJ you have to pay 100% out of pocket until you meet the $2,000 deductible. Even for basic blood work.

Laboratory Outpatient and Professional Services $100 Copay after deductible.

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electric_kite t1_jacfnbm wrote

I can tell you from experience, when I had BCBS Omnia Bronze through the marketplace they did cover blood tests without anything out of my pocket. They also paid toward doctors visits, including specialists, and I also did not pay for ultrasounds. My deductible was high, so I didn’t meet it, but I never paid for basic testing.

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Evening_Attention_45 OP t1_jacnxh2 wrote

Okay hopefully that is the case with me. I’m 43 so maybe that’s why. Idk

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electric_kite t1_jae3gnw wrote

I went through the whole thyroid cancer diagnosis + treatment + follow up experience with good old marketplace insurance, and it sucked, but it could have been way worse and they did pay for a lot of stuff. They never let me hit my deductible, which is bullshit (I was forever $7 short, somehow) and that’s a different gripe altogether, but they did pay a lot without hitting the deductible.

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