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Health Care Reform:

Health Insurance & Affordable Care Act

How to Estimate What You'll Spend on Health Care

Cost Examples: Family, Single, Diabetes, Heart Attack

Review these examples to give you a sense of how your health can affect your out-of pocket costs. Your personal costs could be lower or higher. Health care reform may change this picture, too.

Here are some average out-of-pocket health costs over a year for:

  • An average family of 4: $3,470 for a family in 2012 covered by an employer's preferred provider plan (PPO)
  • A single person: $924 for a single person buying their own insurance
  • A person who recently had a heart attack: $5,000 to $8,000

Ways You May Pay Less Under Health Care Reform

Changes due in 2014 may lower your costs.

Out-of-pocket caps, also called an annual limit. If you're buying a plan from your state's Marketplace (also called an Exchange), health care reform puts a limit on your out-of-pocket costs. In 2014, the most you will pay is about $6,300. For a family, it's about double that.  Your deductible counts toward this cap. Those numbers may look very high. But they at least put an upper limit on what you'd have to spend.

Free preventive care.  You'll have no copayment at all for new baby care, well-child visits, screenings for early signs of disease, like mammograms, and many other services.

WebMD Medical Reference

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