More employer plan enrollees face high out-of-pocket costs

stethoscope on money
In 2015, 12% of enrollees in large employers' health plans spent $2,000 or more annually on healthcare services. (Getty/Maudib)

Over the last decade, more and more people covered by large employers’ health plans have found themselves facing high out-of-pocket healthcare costs, according to a new analysis.

The analysis, produced by researchers at the Kaiser Family Foundation, noted that in 2005, 17% of workers spent $1,000 or more on healthcare services. By 2015, that share had risen to 24%.

For the majority of workers in 2015, out-of-pocket healthcare expenses were just $500 or less, researchers noted. Still, 12% spent $2,000 or more annually.  


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Unsurprisingly, those with costly diseases tended to have the highest out-of-pocket spending. For people undergoing treatment for cancer, for example, out-of-pocket expenses were nearly double that of the average enrollee in 2015.

The other disease categories with the highest out-of-pocket spending included diseases of the blood, congenital anomalies, digestive diseases and circulatory system diseases.

Enrollees who spent money on mental health treatments, meanwhile, were more than doubly likely than the average worker to have out-of-pocket costs exceed $5,000 annually. Among different mental health conditions, out-of-pocket expenses associated with undergoing treatment for a suicide attempt, psychotic disorders and dementia were the highest.

“As the trend of patients with employer plans paying more in out-of-pocket continues, workers and their families feel the burden of healthcare costs even as the growth of health spending in general remains moderate,” the analysis concludes.

Other recent research has indicated that while premiums for employer-based plans continue to grow slowly, part of that trend is attributable to the increased prevalence of high-deductible plans. Such plans have been able to lower costs by decreasing the use of healthcare services, but research shows this can also include necessary, preventive care.

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