Customer Utilization of Obamacare Health Insurance Plans: eHealth Report Highlights Out-of-Pocket Costs
MOUNTAIN VIEW, CA – February 21, 2018 – Today eHealth, Inc. (NASDAQ: EHTH) (eHealth.com), a leading private online health insurance marketplace, published a report highlighting out-of-pocket spending on healthcare services for customer enrolled in major medical “Obamacare” health insurance plans.
Overall Utilization of Healthcare Services
eHealth surveyed over 2,000 of its customers who purchased health insurance in 2017 and compared it to the same survey from 2016. The 2017 survey found that the number of people who did not use their health insurance plan in 2017 had decreased 26% compared to 2016. The survey also found that the number of consumers who said they had used their plan for more than one type of medical service had increased 70% from 2016.
|
Which of the following did you use your health insurance plan for in the last year? |
2017 Responses |
2016 Responses |
2016-2017 Change |
|
“None/not applicable” |
45% |
61% |
-26% |
|
“More than one of these” |
13% |
8% |
+63% |
|
“Maternity care” |
1% |
1% |
0% |
|
“Unexpected surgery (major or minor)” |
4% |
2% |
+100% |
|
“Expected surgery (major or minor)” |
3% |
2% |
+50% |
|
“Emergency care” |
6% |
6% |
0% |
|
“Care for an unexpected illness” |
5% |
3% |
+67% |
|
“Rehabilitative care” |
2% |
1% |
+100% |
|
“Care for a chronic illness” |
6% |
6% |
0% |
|
“Scheduled preventive care screenings” |
13% |
8% |
+63% |
|
“Mental health care” |
2% |
2% |
0% |
|
“Treatment for substance abuse or addiction” |
0% |
0% |
0% |
Altogether, 42% of survey participants said they used their health coverage for medical care (excluding those who used scheduled preventive care only) in 2017.
Among those who used their health coverage to treat a medical illness or injury (non-preventive care) 14 percent used the Emergency Room[JH1] , 14 percent needed care for a chronic illness, 5 percent needed mental health care, 12 percent needed care for an unexpected illness, and 10 percent had an unexpected surgery.
Self-Reported Out-of-Pocket Costs for Healthcare Services
In the survey, eHealth also asked customers to estimate their out-of-pocket costs for the specific medical services they received. Overall, customers estimated that their out-of-pocket spending, before their out-of-pocket maximum was reached, averaged $2,975.
|
How much would you estimate you spent out of your own pocket for these services? |
2017 Survey Responses |
|
”$500 or less” |
18% |
|
”Between $501 and $1,000” |
16% |
|
”Between $1,001 and $1,500” |
10% |
|
”Between $1,501 to $2,000” |
8% |
|
”Between $2,001 and $2,500” |
5% |
|
”Between $2,501 and $3,000” |
6% |
|
”Between $3,001 and $3,500” |
4% |
|
”Between $3,501 and $4,250” |
4% |
|
”Between $4,251 and $5,000” |
5% |
|
”Between $5,001 and $6,000” |
6% |
|
”Between $6,001 and $7,000” |
6% |
|
”Between $7,001 and $8,000” |
4% |
|
”Between $8,001 and $9,000” |
1% |
|
”Between $9,001 and $10,000” |
1% |
|
”From $10,000 to my plan’s out-of-pocket maximum” |
7% |
|
Average |
$2,975.32 |
Average reported out-of-pocket costs among survey respondents who indicated they had used their coverage for medical care are shown below:
|
Care received |
Percent of customers surveyed who used medical care* |
Estimated average out-of-pocket costs |
|
Maternity care |
2% |
$5,068.75 |
|
Unexpected surgery |
10% |
$3,934.23 |
|
Expected surgery |
7% |
$4,555.49 |
|
Emergency care |
14% |
$3,398.68 |
|
Care for an Unexpected illness |
12% |
$2,692.53 |
|
Care for a chronic illness |
14% |
$2,836.78 |
|
Mental health care |
5% |
$2,296.43 |
|
Substance abuse treatment |
0%** |
$2,828.57 |
|
*This data is a subset of those 42% of eHealth customers who reported receiving non-preventive medical care in 2017 **When rounded, fewer than one percent reported receiving care for substance abuse |
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eHealth’s report is based on a voluntary nationwide online survey of eHealth customers between January 1 and December 31, 2017. More than 2,000 responses were collected. All respondents had previously purchased individual or family health insurance plans through eHealth.com, the company’s private online marketplace.
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About eHealth
eHealth, Inc. (NASDAQ: EHTH) owns eHealth.com, a leading private online health insurance exchange where individuals, families and small businesses can compare health insurance products from brand-name insurers side by side and purchase and enroll in coverage online and over the phone. eHealth offers thousands of individual, family and small business health plans underwritten by many of the nation's leading health insurance companies. eHealth (through its subsidiaries) is licensed to sell health insurance in all 50 states and the District of Columbia. eHealth also offers educational resources, exceptional telephonic support, and powerful online and pharmacy-based tools to help Medicare beneficiaries navigate Medicare health insurance options, choose the right plan and enroll in select plans online or over the phone through Medicare.com (www.Medicare.com), eHealthMedicare.com (www.eHealthMedicare.com) and PlanPrescriber.com (www.PlanPrescriber.com).
For more health insurance news and information, visit eHealth's Consumer Resource Center.