Customers signed up in the most popular kinds of Obamacare plans for 2015 won't see big increases in how much they have to pay in out-of-pocket health costs compared to this year, a new analysis finds.
But those individual and family plan customers still are responsible for significantly higher deductibles than people who get health coverage through their jobs, according to the HealthPocket study released Thursday. That said, an increasing number of job-based plans are offering high-deductible options.
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The often-steep Obamacare deductibles, which are on top of monthly premiums that customers have to pay to have insurance, can come as a surprise to enrollees, said Kev Coleman, head of research and data for HealthPocket.
"You're paying a lot of money for health insurance and then you go to use it, and then you say, 'OK, until this deductible is satisfied, I might be paying completely for doctor and specialist visits?'" he said.
Coleman analyzed the deductibles for so-called bronze and silver insurance plans being sold in the 38 states where data were available from the federal government.
Bronze plans, which cover about 60 percent of medical costs, are the most popular and cheapest individual and family plans sold outside the government-run Obamacare exchanges. The only place customers can get subsidies to help them buy coverage are the exchanges, but a substantial number of people buy plans outside of those marketplaces for various reasons.
Silver plans, which cover about 70 percent of health benefit costs, are by far the most popular plans sold on those exchanges.
Well-above IRS definition
HealthPocket found that the average deductible for an individual enrolled in a bronze plan in 2015 will be $5,181, or $100 more than 2014 limits. For families in bronze plans, the deductible next year will be $10,545, or $159 more than this year.
For individuals in silver plans in 2015, they'll have average deductibles of $2,927, or $20 more than this year. The average deductibles for families in silver plans next year will actually decrease by $68, to $6,010.
While HealthPocket didn't see big hikes in the average deductible limits, Coleman noted, "Those are very high amounts" for people to have to pay.
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Coleman pointed out that for 2015, the Internal Revenue Service's definition of a high-deductible plan will be $1,300 for individuals, and $2,600 for families.
For the Obamacare plans, "they're well beyond that definition," Coleman said. Individual Silver plans on average are more than twice the IRS benchmark for high-deductible plans, and such bronze plans are nearly four times the benchmark, he said.
The Obamacare plans also are much pricier, in terms of deductibles, than job-based insurance.
The HealthPocket report noted that "deductibles in employer-sponsored health insurance were $1,217 on average for individual coverage," according to a Kaiser Family Foundation benefits survey in 2014.
But people with job-based coverage shouldn't be gloating, too much.
Mercer, in a survey released Wednesday, said that 2014 had seen "the largest one-year increase in enrollment in high-deductible, consumer-driven health plans, from 18 percent to 23 percent of all covered employees." Among large employers nearly half, or 48 percent, now offer such high-deductible plans, up from 39 percent in 2013, according to the Mercer survey.
The trend toward high-deductible plans comes as insurers and employers grapple with the cost of health care, whose growth continues to outpace the general rate of inflation, despite slowing in recent years. By shifting more costs directly onto insurance enrollees, plan designers hope to encourage more cost-conscious shopping.
Consumers focus on plan costs
Cost remains a primary concern for many current and potential Obamacare enrollees. Multiple studies have shown that price, or the perceived price of insurance is the top reason why uninsured people continue going without health coverage.
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And a Healthline survey released earlier this month found that 69 percent of respondents said they would not pay a higher premium or deductible for better health insurance, or were not sure they would do so. About half of the respondents in the Healthline study said they would go without medical care because of "financial issues or the limitations on their insurance plans."
In another striking finding in the same survey, just 9 percent of respondents said they plan to switch to a different health insurance plan in this ongoing open-enrollment season, which began last Saturday and which ends Feb. 15.
Coleman, echoing the advice of the Obama administration, said that every current Obamacare customer should not automatically accept re-enrollment in their existing plan, but should instead look at the other options they have for 2015.
"Make sure you get out and shop around ... you might find something more attractive," Coleman said.
He said that high deductibles for plans will be of concern "to people who use health care moderately or frequently."
But people who never or who rarely go to the doctor "should be more focused on premiums" and the doctors included in a plan's network, Coleman said.