Insights into Cost-Sharing for 2022 Federal Marketplace Plans
Explore data on cost-sharing for plans offered in the 2022 Federal Marketplace, including the distribution of medical deductibles among different plan tiers and how medical deductibles are combined or separate from prescription drug deductibles. The analysis covers Bronze, Silver, Gold, and Platinum plans, providing insight into the average medical deductibles and changes from 2021 to 2022.
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Cost-Sharing for Plans Offered in Federal Marketplace for 2022
Figure 1 Percent of Plans Where Medical Deductible is Combined or Separate from the Prescription Drug Deductible (2022) Combined Separate 100% 17% 18% 19% 90% 80% 55% 70% 60% 50% 83% 82% 81% 40% 30% 45% 20% 10% 0% Bronze Silver Gold Platinum SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2022. Data are from Healthcare.gov.
Figure 2 Average Medical Deductible in Plans with Combined Medical and Prescription Drug Deductibles (2022) $8,000 $7,051 $7,000 $6,000 $4,753 $5,000 $4,000 $3,000 $2,000 $1,600 $1,000 $111 $0 Bronze Silver Gold Platinum SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2022. Data are from Healthcare.gov.
Figure 3 Average Medical Deductible in Plans with Separate Medical and Prescription Drug Deductibles (2022) $4,000 $3,403 $3,500 $3,000 $2,500 $2,000 $1,567 $1,443 $1,500 $1,000 $459 $500 $0 Bronze Silver Gold Platinum SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2022. Data are from Healthcare.gov.
Figure 4 Distribution of Medical Deductibles Among Bronze Plans, 2021 and 2022 2021 2022 50% 44% 45% 40% 34% 32% 32% 35% 30% 25% 20% 13% 13% 15% 10% 10% 4% 4% 4% 4% 3% 2% 5% 0% $0 $0-$1,500 $1,500-$3,000 $3,000-$4,500 $4,500-$6,000 $6,000-$7,500 $7,500 or more SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2021 and 2022. Data are from Healthcare.gov.
Figure 5 Distribution of Medical Deductibles Among Silver Plans, 2021 and 2022 2021 2022 35% 31% 28% 30% 27% 25% 25% 19% 20% 16% 15% 11% 11% 10% 9% 10% 5% 5% 2% 2% 2% 0% $0 $0-$1,500 $1,500-$3,000 $3,000-$4,500 $4,500-$6,000 $6,000-$7,500 $7,500 or more SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2022. Data are from Healthcare.gov.
Figure 6 Distribution of Medical Deductibles Among All Marketplace Plans, 2021 and 2022 2021 2022 35% 29% 30% 25% 20% 20% 17% 17% 16% 15% 13% 15% 13% 12% 12% 10% 10% 9% 10% 7% 5% 0% $0 $0-$1,500 $1,500-$3,000 $3,000-$4,500 $4,500-$6,000 $6,000-$7,500 $7,500 or more SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2021 and 2022. Data are from Healthcare.gov.
Figure 7 Average Medical Deductible in Plans with Combined Medical and Prescription Drug Deductibles (2022) $5,000 $4,753 $4,500 $4,000 $3,500 $3,215 $3,000 $2,500 $2,000 $1,500 $1,000 $756 $500 $146 $0 Silver with no CSR: Incomes over 250% of FPL (over $32,200 for a single individual) Silver, CSR 73% AV: Incomes 200%-250% of FPL ($25,760-$32,200 for a single individual) Silver, CSR 87% AV: Incomes 150%-200% of FPL ($19,320-$25,760 for a single individual) Silver, CSR 94% AV: Incomes 100%-150% of FPL ($12,880-$19,320 for a single individual) SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2022. Data are from Healthcare.gov. NOTE: FPL refers to Federal Poverty Level. CSR refers to Cost-Sharing Reduction. AV refers to Actuarial Value. Income cut-offs are poverty thresholds for a household of one.
Figure 8 Average Medical Deductible in Plans with Separate Medical and Prescription Drug Deductibles (2022) $4,000 $3,403 $3,500 $3,000 $2,657 $2,500 $2,000 $1,500 $1,000 $658 $500 $161 $0 Silver with no CSR: Incomes over 250% of FPL (over $32,200 for a single individual) Silver, CSR 73% AV: Incomes 200%-250% of FPL ($25,760-$32,200 for a single individual) Silver, CSR 87% AV: Incomes 150%-200% of FPL ($19,320-$25,760 for a single individual) Silver, CSR 94% AV: Incomes 100%-150% of FPL ($12,880-$19,320 for a single individual) SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2022. Data are from Healthcare.gov. NOTE: FPL refers to Federal Poverty Level. CSR refers to Cost-Sharing Reduction. AV refers to Actuarial Value. Income cut-offs are poverty thresholds for a household of one.
Figure 9 Average Out-of-Pocket Limit in Plans with Combined Limit for Medical and Prescription Drug Cost Sharing (2022) $9,000 $8,209 $8,000 $7,000 $6,436 $6,000 $5,000 $4,000 $3,000 $2,591 $2,000 $1,208 $1,000 $0 Silver with no CSR: Incomes over 250% of FPL (over $32,200 for a single individual) Silver, CSR 73% AV: Incomes 200%-250% of FPL ($25,760-$32,200 for a single individual) Silver, CSR 87% AV: Incomes 150%-200% of FPL ($19,320-$25,760 for a single individual) Silver, CSR 94% AV: Incomes 100%-150% of FPL ($12,880-$19,320 for a single individual) SOURCE: KFF analysis of Marketplace plans in states with Federally Facilitated or Partnership exchanges in 2022. Data are from Healthcare.gov. NOTE: FPL refers to Federal Poverty Level. CSR refers to Cost-Sharing Reduction. AV refers to Actuarial Value. Income cut-offs are poverty thresholds for a household of one.
