Consumers who use healthcare moderately could face unnecessary out-of-pocket spending if they purchase a higher tier health plan (e.g. silver over bronze) without looking at deductibles and caps on annual out-of-pocket costs. National averages show that deductibles and out-of-pocket limits get lower as the health plan tier rises, but cost-sharing can still vary significantly among plans within each tier (bronze, silver, gold, platinum).
HealthPocket examined the lowest to highest deductibles and out-of-pocket caps for Affordable Care Act health plans in 34 states. For bronze, silver, and gold plans, the differences in deductibles amounts to thousands of dollars among insurance policies in same category. The largest range was within silver plans. The lowest deductible was $0 and the highest was $6,250. The smallest range was among platinum plans with the lowest deductible at $0 and the highest at $1,000.
Also, a top-tier platinum plan could have a higher cap than an entry-level bronze plan. Both gold health plans and platinum health plans had the widest range of out-of-pocket caps ($4,850 difference from the lowest to the highest cap). HealthPocket also found the small business health insurance market had similar characteristics to the individual and family health insurance market. For more information, visit www.HealthPocket.com.
