(Image: Allison Bell)

Two large health insurance market makers say customers who have to pay the full cost of their individual major medical coverage themselves are facing big increases in premium bills for 2018 coverage.

For consumers who qualify to use Affordable Care Act advance premium tax credits, however, average increases in out-of-pocket spending may be under 10%.


The Data

Analysts at eHealth Inc., the for-profit company that runs the eHealthInsurance.com insurance sales website, has published one batch of data, based on unsubsidized individual major medical purchases made from Nov. 1 through Nov. 20.

(Related: Average Short-Term Health Premium Creeps Lower)

Analysts at Connect for Health Colorado, the state-based Affordable Care Act public health insurance exchange in Colorado, has based its data on its sales of subsidized and unsubsidized individual major medical sales for the period from Nov. 1 through Nov. 21.

The For-Profit Web Broker

At eHealth, which does business throughout the United States, the cost of unsubsidized, bare-bones, bronze-level 2018 coverage is averaging $452 per month, up 21% from the average monthly price for 2017 coverage.

The average monthly cost of mid-level silver plans has increased 23%, to $514, and the average monthly cost of gold plans has increased 22%, to $613.

The ACA Exchange

In Colorado, at Connect for Health Colorado, the average cost of unsubsidized coverage at all richness levels has increased 37%, year over year, to $571 per month.

For Colorado residents who qualify for the Affordable Care Act advance premium tax credit subsidy, the full cost of coverage has increased 30%, to $758 per month.

But, for Colorado residents who qualify for the premium subsidies, the subsidies have also increased.

Because of the increase in the average subsidy level, the net amount the subsidy users are paying out of pocket for coverage has increased just 6.8%, to $157 per month.

About 63% of Connect for Health Colorado’s early applications appear to be coming in through brokers.

Another 7% are coming in from nonprofit helpers, or from people who have received help both from brokers and from nonprofit helpers.

The rest of the purchasers are signing up for coverage entirely on their own, without help from brokers or nonprofit helpers.

—Read 5 Hints About the Fate of This Major Medical World on ThinkAdvisor.


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