The National Defense Authorization Act has a provision barring the military's insurance from covering gender-affirming care for service members' children.
In the US, healthcare is too expensive to afford out of pocket, so most people get health insurance from their employer, as an additional benefit. This covers the employee, their spouse, and their children up to a certain age.
In this case, it looks like people employed by the military will be prevented from getting full healthcare for their children, if those children are transgender.
To be clear, employers subsidize healthcare. They don’t pay all of it.
A pretty standard rate for a family is $1800/month, with the company covering $1200 of that, and you covering $600.
And then when you need care, anything preventative, like normal checkups are free/covered. If the checkup finds something, it’s no longer free. Most plans require you to pay all of it until you reach, say, $8000*. After $8000 in a year, you pay roughly 10%. After, say, $12,000 in a year, all healthcare is covered until January.
The 8k and 12k numbers do not include either the $7200 you pay or the $14,400 your employer pays a year in premium.
So if nothing goes wrong, you pay the minimum of $7200 a year. (And your employer pays $14,400 for you.) If everything goes wrong, you pay $19,200 a year. (And you better hope you don’t lose your job for being sick.)
Everything you’re explaining about the deductible, premiums and out-of-pocket maximum is correct, the only thing I’ll say is the numbers you’re quoting seem pretty high. I work for a company that explains benefits to employees for different US companies, and the majority of plans have an OOP max of around 8k (for families ie employee, spouse and at lease 1 child) with everything being lower for less people. Most plans we work with have a family deductible of around 4k with everything being covered after 8k. Could be explained by working for a shittier company, or living in a higher cost of living area, just wanted to throw in my 2 cents that what you’re describing is definitely on the costlier end of the spectrum.
To be fair yes, monthly premiums for the plans I was referencing were between 1.7k and 2.3k, with them tending to be right above 1.8, so that definitely is a factor here
In the US, healthcare is too expensive to afford out of pocket, so most people get health insurance from their employer, as an additional benefit. This covers the employee, their spouse, and their children up to a certain age.
In this case, it looks like people employed by the military will be prevented from getting full healthcare for their children, if those children are transgender.
To be clear, employers subsidize healthcare. They don’t pay all of it.
A pretty standard rate for a family is $1800/month, with the company covering $1200 of that, and you covering $600.
And then when you need care, anything preventative, like normal checkups are free/covered. If the checkup finds something, it’s no longer free. Most plans require you to pay all of it until you reach, say, $8000*. After $8000 in a year, you pay roughly 10%. After, say, $12,000 in a year, all healthcare is covered until January.
The 8k and 12k numbers do not include either the $7200 you pay or the $14,400 your employer pays a year in premium.
So if nothing goes wrong, you pay the minimum of $7200 a year. (And your employer pays $14,400 for you.) If everything goes wrong, you pay $19,200 a year. (And you better hope you don’t lose your job for being sick.)
Everything you’re explaining about the deductible, premiums and out-of-pocket maximum is correct, the only thing I’ll say is the numbers you’re quoting seem pretty high. I work for a company that explains benefits to employees for different US companies, and the majority of plans have an OOP max of around 8k (for families ie employee, spouse and at lease 1 child) with everything being lower for less people. Most plans we work with have a family deductible of around 4k with everything being covered after 8k. Could be explained by working for a shittier company, or living in a higher cost of living area, just wanted to throw in my 2 cents that what you’re describing is definitely on the costlier end of the spectrum.
Are those premiums higher than $1800/month? (With employer contribution as part of that.)
Of course my numbers are from memory and likely aren’t accurate. But I think they aren’t far off my last plan.
To be fair yes, monthly premiums for the plans I was referencing were between 1.7k and 2.3k, with them tending to be right above 1.8, so that definitely is a factor here
In my experience, going above whatever “Bronze” plan required you to hit very specific spending targets in order to come out ahead.
Generally everyone’s just better off with the bronze plan unless you know you’re going to spend at least X this year.
For non-Americans, poster above me is talking about the deductable, co-insurance, and then max out of pocket.
The one thing I’d argue is inaccurate is the 10% co-insurance rate.
If you have an insurance with ONLY a 10% co-insurance, you have good insurance. 25-50% is far more usual.