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Compare your health care costs and services

6:50 PM, Nov. 2, 2013  |  Comments
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Are you frustrated with rising health care costs? Do you wonder how your health care costs compare with other people? Are you wondering how the Affordable Care Act will affect you?

Most employers require employees to pay part of their health insurance premiums. In 2013, the average health insurance premium for employer provided family coverage was $16,351, and the average employee contribution toward the premium was $4,565. The average premium for employer provided health care for a single employee was $5,884, and the average employee share was $999.

Employees in businesses with less than 200 employees generally pay a smaller percentage of their pay for single coverage (16 percent of their pay versus 19 percent of pay for larger employers). Employees in smaller businesses pay an average of 36 percent of the premiums for family coverage compared with 26 percent of premiums for employees in large businesses.

In 2003, the average premium for employer provided family coverage was $9,068 and the employee's share of that premium was $2,412. In 10 years, premiums have increased 80 percent and the average worker's share of premiums has increased 89 percent.

An 89 percent increase wouldn't seem so bad if wages kept up with cost increases. What would an 89 percent wage increase look like? Someone earning $50,000 in 2003 would earn $94,500 in 2013. Wages have not kept up with cost increases.

As health care costs rose dramatically, many plans adopted employee cost-sharing measures such as deductibles, co-payments and co-insurance. For example, by 2013, the average deductible for single coverage was $1,135 annually and 78 percent of covered workers have a deductible.

Most plans have an out of pocket maximum amount that employees must pay each year. However, not all spending is counted toward those "maximum" limits. For example, 76 percent of employees in PPOs don't count physician office co-payments and 84 percent don't count prescription drug spending. The Affordable Care Act will require that all non-grandfathered plans count all cost sharing toward the annual out of pocket maximum.

The 2013 Milliman Medical Index pegs the total cost of medical care for a typical family of four at $9,144. How do your costs compare?

It may be harder to really compare costs now with costs in 2014, because in 2014 preventive care will be covered at no cost in non-grandfathered plans. There won't be a co-pay or co-insurance cost for these services. Also, some people will qualify for subsidies that will make their premiums more affordable.

Given the sweeping magnitude of the changes, it's probably too early for many people who have health coverage to accurately assess what care will really be like under the ACA and how much it will cost. To learn more about the impact of the new law, you might check out www.thedacare.org.

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