New Report: Low Out-Of-Pocket Health Plans Could Save Hundreds of Millions

On a media call today Citizen Action of Wisconsin released a new report: “Out-Of-Pocket Relief: How Insurance Companies Could Reduce Skyrocketing Consumer Health Costs by Offering Better Plans”. The report documents the millions in health out-of-pocket cost savings available if insurance plans followed new federal suggestions to introduce Low Out-Of-Pocket Health Plans by the July 22nd deadline. Joining the call were State Senator Chris Larson and Dr Kesavan Kutty of the American College of Physicians - Wisconsin Chapter. The audio of the call can be heard here.

For the first time, the federal government is encouraging insurance companies that offer plans on to introduce Low Out-Of-Pocket Health Plans. Wisconsin insurers must decide whether to do so before a July 22nd deadline. A main feature of Low Out-Of-Pocket Health Plans is the elimination of deductibles on many health services and all prescription drugs. This represents thousands in annual savings for the average consumer.

Key Facts

  1. For 2016 individual Silver plans sold on in Wisconsin have on average $3,347 medical deductibles and $1,203 prescription drug deductibles before insurance pays any costs.

  2. If Wisconsin health insurers offer “Low-Out-Of-Pocket” health plans in 2017 annual deductibles for doctor's visits (primary or specialist), urgent care, and for all prescription drugs would be $0.

  3. Potential prescription drug savings vary dramatically by region. Residents in Janesville would save on average $618 a year in drug costs, while those in Oshkosh would save $2,023 annually.

  4. Potential reductions in deductibles for doctor visits also vary by region, with $2,855 saved per year in Superior to $3,702 saved per year per person in Milwaukee.

  5. If Wisconsin insurers offer “Low Out-Of-Pocket” for 2017, and 25% of all Wisconsin consumers purchasing on enroll, they would see a collective reduction in medical and prescription drug deductibles of over $270 million per year.


See the full report here

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