Today we’re diving into Open Enrollment, which is coming up fast. I know it’s only September, but trust me, it’ll be here before you know it. Every year, we see changes—new plans, premium adjustments, and one of the biggest shifts people often overlook: deductibles and out-of-pocket maximums.

Deductibles & Out-of-Pocket Max: What to Expect

For those of you already stressed about your high deductible or out-of-pocket maximum, take a deep breath! It’s important to remember that deductibles mainly kick in when you have a big medical event, like an ER visit or hospital stay. Many plans still allow you to pay a simple copay when you see your doctor, so the deductible isn’t always something you’ll face regularly. However, when it comes to larger services—like surgeries or hospitalizations—you’ll almost always have to meet that deductible first.

Some plans are what I call “all-in” plans—they don’t cover anything except wellness visits until you hit that deductible. But for most of my clients, I recommend plans with copays for doctor visits so you don’t have to worry about a large deductible every time you need routine care. Keep in mind that things like ER visits, hospital stays, labs, and sometimes prescriptions often fall under the deductible umbrella.

Planning for the Unexpected

So, what happens when life throws you a curveball and you end up needing surgery or getting admitted to the hospital? That’s when your deductible and out-of-pocket max come into play. To help with these potential costs, I want to introduce you to something that could be a game-changer for you and your family: the Out-of-Pocket Protection Plan.

This plan has a range of options, from $2,500 to $10,000, that can help offset the financial impact if you or a loved one ends up in the hospital. It can cover your deductible, out-of-pocket max, and more, giving you some serious peace of mind.

Key Benefits of the Out-of-Pocket Protection Plan:

• Hospital Admission Benefit: This pays out if you’re admitted to the hospital, which can help cover your deductible or out-of-pocket max.
• Daily Hospital Benefit: If you’re in the hospital for more than one day, you’ll get a daily payout (either $100 or $200 per day). This could be a lifesaver if you’re facing a longer hospital stay.
• Additional Coverage: You can add benefits for outpatient surgeries and ER visits, offering even more protection if something unexpected happens.

How It Works

This plan pays cash directly to you, not to the hospital or the insurance company. You can use this money however you need—whether it’s covering medical bills or taking care of other expenses while you recover. The process is straightforward: once you have your itemized hospital bill, including your admission and discharge dates, we submit it to the protection plan, and they’ll send you a check.

In many cases, you’ll get the money before the hospital even bills you, since hospitals often take time to process everything with your insurance. This can be a huge relief when unexpected expenses pop up.

Affordable Peace of Mind

The cost of this plan varies depending on the options you select, but to give you an idea, I had a couple in their 50s choose a $5,000 plan for only $85 a month. That’s a small price to pay for the financial security it provides, especially in the event of a major hospital stay.

Ready to Get Started?

You don’t have to wait until Open Enrollment to get this coverage—you can sign up now! Just visit my page at JKappConsulting.com or follow the link to enroll. If you’d prefer to chat about your options, I’m always here to help. Some people like the DIY approach, and that’s totally fine—this plan makes it easy to self-enroll if that’s your style.

Let’s make sure you’re covered for any curveballs life throws your way! Until next week—peace out and stay protected!