ACA's Out-of-Pocket Costs Changing for 2015

July 14, 2014
Adam Hochron

In 2015, the level of affordability under the Affordable Care Act will be changing depending on the plan people signed up for, according to a report from Healthpocket.

The level of affordability under the Affordable Care Act (ACA) in 2015 looks to be changing depending on the plan people sign up for, according to a report from Healthpocket.

For those who registered for the bronze, silver, and gold plans, out-of-pocket expenses in the second year will decrease. Estimates for the upcoming year report the bronze plan will drop by less than 1% while the silver plan will drop by 9% and the gold plan by 12%.

Those numbers are far more encouraging than estimates for platinum level members. The average deductible for an individual enrollee with a platinum plan will increase as much as 43%. An individual paying $347 for platinum coverage in 2014 will see that number jump considerably to $497 in the upcoming calendar year.

ACA participants will also see changes in their costs for going to see doctors and specialists, according to Healthpocket. At the bronze level, copays are more popular than a coinsurance charge, where patients are paying a percentage of the costs for seeing a doctor. The coinsurance remains a mainstay of the specialist visits and also looks to have a 17% increase, according to cited government filings.

While silver and gold members will see their costs for doctor and specialist fees go down, the latest reports have platinum members paying slightly more for both. That would mean an increase from $16 to $19 for doctor visits and a meager move from $30 to $31 for specialists.

Kev Coleman, Head of Research and Data for Healthpocket, said in a statement that premiums have been a focal point of the upcoming year for the ACA.

“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,” he said.

Data for the report was collected from 9 specific states: Arizona, Connecticut, Indiana, Maine, Michigan, North Carolina, Rhode Island, Tennessee, and Virginia.

All rates need approval from their respective state departments of insurance before they can be put into effect for patients.