but your question is terrifying. Start with a medical social worker? Good luck to you.

I think you may be confusing max out of pocket with the maximum amount your policy will pay. If that's the case, you can rest easy. Max out of pocket means that your policy will now cover the percentage of your medical expenses that you have been covering yourself. In other words, If you normally have had pay 20% of your medical costs out of your own pocket, while your insurance has picked up the remaining 80%, your policy will now cover 100% of covered expenses for the rest of the year. The Affordable Care Act prohibited policy maximums (ie., they would only pay a set amount annually or for your lifetime)l so it's very, very, very unlikely that you have one, whether you have regular health insurance or Medicare Advantage.

this is my wifes 2nd time around with the disease and the numbers I'm seeing are so insane they can never be paid and I don't want to lose the house. I tried to talk her into a medicare trust years ago but she wanted nothing to do with that, go figure.

The Affordable Care Act also made it illegal for insurance companies to deny coverage for pre-existing conditions.

But they got me anyway, now I have a hole in
my stomach where my guts used to be.

the out of pocket maximum with private insurance, the problem is that it resets each year and can quickly drain savings

The hospital should have social worker on staff so I would start there, if your wife is eligible for Medicare or Medicare disability that will help. Also ask about the possibility of "Dually Eligible" Criteria is determined by the state but the social worker can help!


https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/medicare_beneficiaries_dual_eligibles_at_a_glance.pdf


People who have both Medicare & Medicaid

https://www.medicare.gov/basics/costs/help/medicaid

"People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you’re a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.

If you're dually eligible, Medicare covers your prescription drugs. You’ll automatically be enrolled in a Medicare drug plan that will cover your drug costs instead of Medicaid. Medicaid may still cover some drugs that Medicare doesn’t cover.

You can still pick how you want to get your Medicare coverage: Original Medicare or Medicare Advantage (Part C). Check your Medicare coverage options... "

you might qualify for disability or unemployment benefits?

Not sure... (Social Security first said I met standards for disability, but didn't provide benefits.)