A data analysis reveals that expenses for deductibles and other out-of-pocket costs are changing inconsistently among the four categories of Accountable Care Act plans.
To determine if 2015 will bring any significant changes in health insurance cost-sharing, Sunnyvale, Calif.-based health plan and cost comparison platform HealthPocket examined out-of-pocket costs in public rate filings for ACA plans within nine states. Among the findings:
Bronze plans had a decrease in deductible with an increase in specialist copayments, and a higher maximum for annual out-of-pocket costs
Silver plans had decreases in deductibles, doctor copayments, specialist copayments, and maximum annual out-of-pocket costs
Gold plans had decreases in deductible, doctor copayments, and specialist copayments but an increase with respect to its maximum for annual out-of-pocket costs
Platinum plans had increases in deductible, doctor copayments, and specialist copayments but a decrease in its maximum annual out-of-pocket costs
HealthPocket also noted that the actuarial values requirements for the different categories of ACA health plans have not simplified the health plan shopping process as originally intended. While the actuarial value (the percentage of medical expenses paid by an insurer) changes evenly among the different categories of plans, the resulting changes in deductibles and physician copayments did not change proportionally with the actuarial value changes.
"Early media attention of the 2015 Obamacare plans has focused on premiums," said Kev Coleman, head of research and data at HealthPocket, "but out-of-pocket costs are just as important inasmuch as they can represent thousands of dollars in annual expenses for a consumer who uses healthcare services regularly."
This story first appeared at Health Data Management.
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