Right now I am the proud named insured of a fine 80/20 insurance plan through my employer.
My employer pays 80% of UCR charges, I pay the other 20% of the charges.
Out of curiousity, are there companies out there that would be willing to write a policy for the other 20% of my charges? My wife has a bad habit of getting sick often often to make the 20% more actual cash dollars annually than I’d like. Even if I wound up paying slightly more than the other 20%, it’d be nice to know I wouldn’t have to worry about abrupt bumps in my budget.
We have a co-op/hmo. All we pay is a $5.00 co-pay for office and ER visits. The co-pay is $50.00 for hospitalization. I think $200.00 for surgery.
A *typical * plan works like this:
Medical expenses are paid at 100% by the insured until the deductible is met.
Further medical expenses are paid according to a coinsurance %age (80/20, for example) until the “stop loss” amount is met.
The balance of medical expenses are paid at 100% by the insurer.
Policies exist with 90/10 & 100% coinsurance. They get pretty spendy, however. Of course, “spendy” is a relative term if you & your doctor are on a first name basis and he’s candid enough to refer to you as “his BMW payment.”
Availability of different plans varies widely from state to state due to a number of factors–shop around, pal, the grail is out there!
As an alternative to a 100% plan, consider a lower deductible (increases the premium)
a lower “stop loss” amount (increases the premium)
or a supplemental policy, possibly called “Hospital Income” or something similar.
The “Hospital Income” policy is set up to pay a stated amount for every 24 hour period you are hospitalized (say, $125). It may also have a provision to pay 5 times that amount if you go to the ER and are treated (so, you slice open your thumb and get stitches–ka-ching, $625 brass in pocket to put toward your deductible & coinsurance, or to buy flowers & beer with, or whatever–no strings attached, and NON TAXABLE(federal) because it’s an insurance benefit.) 
These policies are cool because they can allow you to save money on your Major Medical policy by using higher deductibles & higher stop losses & less-favorable coinsurance %ages (Which really aren’t less favorable: If you have a $5,000 stop loss, that’s your stop loss regardless of whether you get there by paying 50% or 20% of your medical bills.) Often, the savings you realize by these modifications to your Major Medical plan are substantially greater than your outlay for the Supplemental Insurance.
I am not licensed to sell insurance in any state.
Thank you. I am now investigating “Hospital Income” policies.