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Depending on Plan Type Obamacare Deductibles Average from $5,181 to $243

  • Synopsis: Published: 2014-11-20 - HealthPocket examines deductibles and out-of-pocket costs for 2015 Affordable Care Act health plans - HealthPocket (

The Affordable Care Act was signed into law to reform the health care industry by President Barack Obama on March 23, 2010 and upheld by the supreme court on On June 28, 2012. The official name for "ObamaCare" is the Patient Protection and Affordable Care Act (PPACA). It is also commonly referred to as Obama care, health care reform, or the Affordable Care Act (ACA). ObamaCare does not replace private insurance, Medicare, or Medicaid, nor does ObamaCare regulate your health care, it regulates health insurance and some of the worst practices of the for-profit health care industry.

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Quote: "Out-of-pocket costs for doctor visits and specialist visits fluctuated among the different ACA plan types."

Bronze plans, the most frequently purchased plan off-exchange, averaged a $5,181 deductible for individuals, up from $5,081 in 2014.

The 2015 average amount is 326% higher than the average deductible documented for employer-sponsored health plans.

Silver plans, the most frequently purchased plans on-exchange, averaged $2,927 as the deductible amount for individuals.

The average deductible amount for families was $10,545 and $6,010 for bronze and silver plans respectively.

The average deductible for 2015 gold plans is $1,198 and top-tier platinum plans averaged only $243 for an individual deductible. In both cases, these averages were lower than the averages observed for 2014 ($1,277 for gold plans and $347 for platinum plans).

Out-of-pocket costs for doctor visits and specialist visits fluctuated among the different ACA plan types.

Doctor and specialist visits were 13% more expensive (34% coinsurance fee average in 2015 vs. 30% coinsurance fee average in 2014) for bronze plans.

Gold plans, in contrast, saw the average doctor visit copayment decline from $24 in 2014 to $23 in 2015. Likewise, their average copayment for specialist visits declined from $46 in 2014 to $45 in 2015.

Silver and gold plans separately had both increases and decreases in these two categories of physician visit cost-sharing.

For consumers making 250% or less of the Federal Poverty Level, the government provides reductions on deductibles, co-payments, and coinsurance fees. These out-of-pocket reductions can only be obtained in silver plans for those enrollees whose income qualifies.

"In 2015, the most popular plans sold on and off exchange have average deductibles that remain well above the entry-level classification for a high-deductible health plan," said Kev Coleman, Head of Research & Data at HealthPocket, "however, consumers should remember that averages characterize a range of options and lower-cost deductibles may still be available in their regions."

See HealthPocket's InfoStat "2015 Obamacare Deductibles Remain High But Don't Grow Beyond 2014 Levels" for the full findings on 2015 Affordable Care Act deductibles and out-of-pocket costs. is a free website that compares and ranks all health insurance plans, helping individuals, families, and small businesses to make their best health plan decisions.

HealthPocket publishes health insurance market analyses and other consumer advocacy research. HealthPocket's research is nonpartisan and 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. HealthPocket, Inc. is independently managed and based in Sunnyvale, California. Learn more at

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  3. Majority of Americans Unaware of Impact of Affordable Care Act - HealthMarkets, Inc. - (2014-10-15)

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