Cost-sharing for plans offered in the Federal Marketplace for 2016

1. Cost-Sharing for Plans Offered in
the Federal Marketplace for 2016

2. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2016 (including Arkansas, New Mexico, Oregon, Kentucky and Nevada). Data are from Healthcare.gov. Health
plan information for individuals and families available here: https://www.healthcare.gov/health-plan-information-2016/
89%
56%
43%
27%
11%
44%
57%
73%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Bronze Silver Gold Platinum
Separate
Combined
Percent of Plans Where Medical Deductible is Combined with
or Separate from the Prescription Drug Deductible (2016)
Figure 1

3. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2016 (including Arkansas, New Mexico, Oregon, Kentucky and Nevada). Data are from Healthcare.gov. Health
plan information for individuals and families available here: https://www.healthcare.gov/health-plan-information-2016/
$5,765
$3,064
$1,247
$21
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
Bronze Silver Gold Platinum
Average Medical Deductible, in Plans with Combined Medical
and Prescription Drug Deductibles (2016)
Figure 2

4. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2016 (including Arkansas, New Mexico, Oregon, Kentucky and Nevada). Data are from Healthcare.gov. Health
plan information for individuals and families available here: https://www.healthcare.gov/health-plan-information-2016/
$5,500
$3,198
$1,136
$409
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
Bronze Silver Gold Platinum
Average Medical Deductible In Plans with Separate Medical
and Prescription Drug Deductibles (2016)
Figure 3

5. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2016 (including Arkansas, New Mexico, Oregon, Kentucky and Nevada). Data are from Healthcare.gov. Health
plan information for individuals and families available here: https://www.healthcare.gov/health-plan-information-2016/. 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.
$3,064
$2,491
$709
$221
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
Silver with no CSR:
Incomes over 250% of FPL
(over $29,425 for a single
individual)
Silver, CSR 73% AV:
Incomes 200%-250% of FPL
($23,540-$29,425 for a single
individual)
Silver, CSR 87% AV:
Incomes 150%-200% of FPL
($17,655-$23,540 for a single
individual)
Silver, CSR 94% AV:
Incomes 100%-150% of FPL
($11,770-$17,655 for a single
individual)
Average Medical Deductible In Plans with Combined Medical
and Prescription Drug Deductible (2016)
Figure 4

6. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2016 (including Arkansas, New Mexico, Oregon, Kentucky and Nevada). Data are from Healthcare.gov. Health
plan information for individuals and families available here: https://www.healthcare.gov/health-plan-information-2016/. 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.
$3,198
$2,553
$617
$145
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
Silver with no CSR:
Incomes over 250% of FPL
(over $29,425 for a single
individual)
Silver, CSR 73% AV:
Incomes 200%-250% of FPL
($23,540-$29,425 for a single
individual)
Silver, CSR 87% AV:
Incomes 150%-200% of FPL
($17,655-$23,540 for a single
individual)
Silver, CSR 94% AV:
Incomes 100%-150% of FPL
($11,770-$17,655 for a single
individual)
Average Medical Deductible In Plans with Separate Medical
and Prescription Drug Deductibles (2016)
Figure 5

7. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2016 (including Arkansas, New Mexico, Oregon, Kentucky and Nevada). Data are from Healthcare.gov. Health
plan information for individuals and families available here: https://www.healthcare.gov/health-plan-information-2016/. 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.
$6,160
$4,850
$1,795
$874
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
Silver with no CSR:
Incomes over 250% of FPL
(over $29,425 for a single
individual)
Silver, CSR 73% AV:
Incomes 200%-250% of FPL
($23,540-$29,425 for a single
individual)
Silver, CSR 87% AV:
Incomes 150%-200% of FPL
($17,655-$23,540 for a single
individual)
Silver, CSR 94% AV:
Incomes 100%-150% of FPL
($11,770-$17,655 for a single
individual)
Average Out-Of-Pocket Limit In Plans with Combined Limit for
Medical and Prescription Drug Cost Sharing (2016)
Figure 6