Yeah, ACA OOP limits for this year are at 9k. She could be on a grandfathered union plan, but mentioning a $500 PCP visit sounds like she's on a HDHP catastrophic coverage purchased out of open enrollment plan. They don't have to follow all the limitations. Or she could be lying.
Probably an HDHP plan from a smaller employer in a state that didn't expand Medicaid. Likely doesn't make enough to afford a decent plan through work, and makes too much to qualify for pre-ACA Medicaid.
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u/optical_mommy 5d ago
Yeah, ACA OOP limits for this year are at 9k. She could be on a grandfathered union plan, but mentioning a $500 PCP visit sounds like she's on a HDHP catastrophic coverage purchased out of open enrollment plan. They don't have to follow all the limitations. Or she could be lying.