Expect Increased Out of Pocket Expenses in 2014

As the Affordable Care Act (Obamacare) takes effect in 2014, the greatest change noticed by most will be the unexpected increase in out of pocket expenses.  Required by law (individuals now and employers next year), generally healthy individuals and families will often choose the health insurance plan with the lowest monthly cost.  As with any insurance, however, the lowest premiums come with the highest out of pocket expense.

This year, high deductible plans may reach over $6,000 for an individual and over $12,000 for a family before insurance pays. One outpatient surgery at a typical hospital will approach this amount when the allowed facility fee is added to other fees for the surgeon, anesthesiologist, and testing (pathology, radiology, labs and other tests).

Generally healthy individuals or families with a high deductible insurance plan in need of an outpatient elective ENT surgical procedure now have the opportunity to save thousands by choosing a cash option for surgery.  Our common procedures are priced well below the maximum yearly out of pocket maximum for many of these high deductible plans.


Minimum deductible (single)

Minimum deductible (family)

Maximum out-of-pocket (single)

Maximum out-of-pocket (family)

2009 $1,150 $2,300 $5,800 $11,600
2010 $1,200 $2,400 $5,950 $11,900
2011 $1,200 $2,400 $5,950 $11,900
2012 $1,200 $2,400 $6,050 $12,100
2013 $1,250 $2,500 $6,250 $12,500
2014 $1,250 $2,500 $6,350 $12,700