I'm seeing extremely high out-of-pocket estimates, is this true?

Not exactly. The "out-of-pocket estimate" you see for a plan is just a possible amount someone may spend based off of that plan's benefits and can be skewed by information on your health profile.

The out-of-pocket estimate you see on our site is what people enrolled on that plan are projected to spend on medical services on top of their monthly premium payments based off predicted medical expenses.

Entering a more expensive, branded prescription can cause the out-of-pocket estimate to look extremely high if our site determines that drug would cost the "full price" (to err on the safe side and protect our members from surprise costs when they show up at the pharmacy).

If you have your eye on a specific health plan, our team is happy to check in on how much your non-generic medications will actually cost. This check-in will likely yield a more optimistic forecast for that out-of-pocket estimate you're seeing.