Suggest me if this Base PPO benefit plan is good or not and if not what is it which looks risky?

Question

Plan Year Deductible is $150 individual.

Out-Of-Pocket Maximum is : None

Co-insurance is: 80% after deductible.

Life-Time Maximum Benefit is: Unlimited

Plan Year Maximum Benefit is: outpatient service $5000 and Combined maximum for all services: $24000.

I am ususally healthy other than Cold/Flu or minor health problems. And this plan is by HealthWins Base PPO

Answer 1

Well, if you have a big problem, like cancer, you're going to end up owing hundreds of thousands of dollars.    You have VERY low limits of coverage.  It's really only going to be good for minor stuff.

Answer 2

This is not a good plan.   It will only pay a max of 24K in any one year.  A routine surgery could easily rack up that much.  

My suggestion is look at higher deductibles with more coverage on the high end.  Especially something that may cap out of pocket maximums.

Answer 3

Forget the minimal maximum benefit for a second, the biggest problem I see is there is no max out of pocket. You always want to have a max out of pocket so you know the maximum amount your on the hook for in a given year. Once that max is reached, which one good trip to the emergency room or unforseen disease could eat up, you're on a free ride for the rest of the year.