This has now happened to both my Australian born roommate and one of my HIV patients at the pharmacy. When HR sends out the email to pick out insurance, anyone with a middle class income gravitates towards the cheapest plan possible. No one reads what it means to have a bottom tier plan, all they see is how much per month they have to pay. My HIV patient had a Bronze level plan that gave him a $4000 deductible and 10% copay after that. So when I ran his medications, there was nothing under $200, with several being over $1000. Needless to say, he was shocked. My roommate had it even worse, as it was a minimal basic plan that did not cover any meds and only covered $100 on any other issue. And she wound up with cysts that required an $80k surgery. She had to go back to Australia for the surgery. If someone had just explained to either one of these people how deductibles and a percentage based copay works, there’s no way that plan would be chosen.