The least expensive plans under the Affordable Care Act (ACA) come with higher out-of-pocket costs compared to existing plans in the individual and family insurance market. Bronze Plan filings from California and six other states indicate that consumers may pay more in deductibles, copayments, and coinsurance for their medical services under these entry level plans compared to what they pay now, according to an analysis of early health insurance rate filings by HealthPocket.
Based on a review of over 9,500 health plans in the individual and family health insurance market, copayments for doctor visits were estimated at $28 on average. In comparison, Bronze plans averaged a $41 copayment — an increase of 46%. The lowest Bronze Plan copayment for a doctor was $15 and the highest was $60.
In the pre-reform market, 37% of health plans include doctor visits as part of the deductible. For the new Bronze Plan filings, 84% had doctor visits subject to the deductible. Bronze plan consumers are likely to be charged the full amount for some doctor visits until they have met their plans’ deductible. However, in California, it is standard plan design that the deductible will not be applied for the first three doctor visits. In the seven states where HealthPocket examined rate filings, the average medical deductible was $3,589. In those same states, the Bronze Plans’ average medical deductible was 26% higher at $4,509. For more information, visit www.HealthPocket.com.
