SUNNYVALE, Calif., Jan. 22, 2014 /PRNewswire-USNewswire/ -- For consumers who use healthcare moderately, unnecessary out-of-pocket spending can result if a higher tier health plan (e.g. silver over bronze) is purchased without confirming that the lower tier options in the area have more costly deductibles and caps on annual out-of-pocket costs. Even though national averages show deductibles and out-of-pocket limits getting lower as the health plan tier rises (bronze, silver, gold, platinum), cost-sharing can still vary significantly among plans within each tier.
In order to demonstrate the range of cost-sharing within each health plan tier, HealthPocket examined the lowest to highest deductibles and out-of-pocket caps for the new Affordable Care Act health plans in 34 states. In three of the four health plan tiers (bronze, silver, and gold) HealthPocket saw deductible ranges spanning thousands of dollars among insurance policies belonging to the same category. The largest range was within silver plans where the lowest deductible recorded was $0 and the highest was $6,250. The smallest range was among platinum plans where the lowest deductible was $0 and the highest was $1,000.
HealthPocket found a situation with out-of-pocket cost caps similar to what was found for deductibles. For example, there was the possibility that 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 as observed for the individual and family health insurance market.
"The inventory and cost-sharing burdens of health plans can vary widely from one region to another," said Kev Coleman, Head of Research & Data at HealthPocket, "The 'devil is in the details' so consumers need to take their time and review all their health plan options, both on exchange and off exchange, carefully before enrolling in a particular plan."
Consumers are advised to examine their local health plan options carefully, judging cost-sharing individually rather than based on averages for a plan's particular metal tier category. Failure to follow this advice could result in some unpleasant surprises with respect to deductibles and out-of-pocket expense limits. The full results of HealthPocket's research can be reviewed at "Consumers Risk Higher Healthcare Costs When Using Shortcuts in Health Plan Shopping."
HealthPocket.com is a free website that compares and ranks all health insurance plans available to an individual, family, or small business to allow consumers to make their best health plan decision and reduce their out of pocket costs. HealthPocket uses only objective data from government, non-profit, and private sources that carry no conditions that might restrict the site from serving as an unbiased resource. Learn more at www.HealthPocket.com.