Reply #62: So you probably prefer Medicare, which has no out-of-pocket max.

[bornskeptic]

The max in the Senate bill is $5950 for an individual, and $11,950 for a family. For most people without major chronic health problems the out-of-pocket max will seldom, if ever, come into play. All preventive care would be covered without cost sharing, and in a plan with 70% actuarial value an individual would typically have to acumulate well over $20,000 in medical bills to reach the out-of-pocket max. You might have a $1000 deductible and 30% coinsurance, but that's all based on the insurer's negotiated provider reimbursements, which are considerably lower than the amount you would be billed if you didn't have insurance. Under Medicare with its 20% uncapped coinsurance, you would have to reach about $30,000 in covered expenses to have $6000 in out-of-pocket expenses, but $100,000 in covered expenses would mean $20,000 in out-of-pocket costs, whereas with insurance from the exchange it would still only be $5950.