Assume you may end up paying $500/mo for yourself in the US, or more. It gets worse as you age, and if you need a better plan (to control deductibles, etc) it'll cost you more. Last time I freelanced (at age ~28) it cost me about that much for a mediocre Kaiser plan in California.
> and if you need a better plan (to control deductibles, etc)
I switched to an ACA marketplace plan this year, and... there are no caps for 'out of network' services. "Out of network" deductible is $35k/person. "Out of network" max "out of pocket" is "no max". Insane. And this is a $1100/month plan for 2 people.
"For the 2022 plan year: The out-of-pocket limit for a Marketplace plan can’t be more than $8,700 for an individual and $17,400 for a family."
However, above that it also says:
"The out-of-pocket limit doesn't include:
Costs above the allowed amount for a service that a provider may charge"
The way this has always worked for me is that if the billed amount is $1000 and the max allowed amount is $600, then $600 is what is owed and the rest is "written off" by the provider. If I haven't met the max out-of-pocket yet, I pay first. Then insurance pays $600 - what I paid.
But the way it is worded on the ACA page, it sounds like the provider can bill me directly for the $400 that was disallowed. That has never happened to me (Ambetter/MHS insurance in Indiana), and seems bizarre to have a max out-of-pocket that is not actually enforced.
"The out-of-pocket limit for a Marketplace plan..."
It's capped for 'in network' stuff. But 'out of network' - the infamous phrase that... you can hardly ever really know ahead of time... it's 'no max'.
This is a plan purchased directly from the ACA marketplace, so either they're all in violation of their own rules or... the "in network" is all they mean.
And that 'out of pocket' is still sort of crazy because "premiums" don't count. Our premiums would be around $12k year, but then we can have another ~$18k of fees on top of that before. $12k PLUS another $7k of 'deductible' before there's any insurance kicking in (beyond 'negotiated discount rates').
Had an ER visit last year - $4k. Miraculously, with all the insurance I have (earlier, before the ACA plan), we still owed over $2k of that... Insurance 'negotiated rate' brought things down some, but $2k (plus another $600 for ambulance ride).
I really fear getting sick or injured here the older I get
You would basically need to appeal to your state health regulator if the insurer tries to pull stuff like that with you (they will). I had one insurer kick me off in violation of ACA policies and I had to appeal to California's regulator.
