The document analyzes cost-sharing structures for health plans offered on the Federal Marketplace in 2018. It finds that 92% of bronze plans and 59% of silver plans combine the medical and prescription drug deductibles, while separate deductibles are more common in gold and platinum plans. Average deductibles are highest in bronze plans and lowest in platinum plans, and deductibles are reduced for lower-income enrollees receiving cost-sharing subsidies in silver plans.

1. Cost-Sharing for Plans Offered in
the Federal Marketplace for 2018

2. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2018 (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-2018/
92%
59%
44% 42%
8%
41%
56% 58%
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 (2018)
Figure 1

3. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2018 (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-2018/
$6,002
$4,034
$1,194
$52
$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 (2018)
Figure 2

4. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2018 (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-2018/
$5,938
$3,999
$1,466
$350
$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 Separate Medical
and Prescription Drug Deductibles (2018)
Figure 3

5. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2018 (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-2018/. 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.
$4,034
$2,973
$817
$234
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
$4,000
$4,500
Silver with no CSR:
Incomes over 250% of FPL
(over $30,150 for a single
individual)
Silver, CSR 73% AV:
Incomes 200%-250% of FPL
($24,120-$30,150 for a single
individual)
Silver, CSR 87% AV:
Incomes 150%-200% of FPL
($18,090-$24,120 for a single
individual)
Silver, CSR 94% AV:
Incomes 100%-150% of FPL
($12,060-$18,090 for a single
individual)
Average Medical Deductible In Plans with Combined Medical
and Prescription Drug Deductible (2018)
Figure 4

6. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2018 (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-2018/. 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.
$3,999
$3,112
$653
$183
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
$4,000
$4,500
Silver with no CSR:
Incomes over 250% of FPL
(over $30,150 for a single
individual)
Silver, CSR 73% AV:
Incomes 200%-250% of FPL
($24,120-$30,150 for a single
individual)
Silver, CSR 87% AV:
Incomes 150%-200% of FPL
($18,090-$24,120 for a single
individual)
Silver, CSR 94% AV:
Incomes 100%-150% of FPL
($12,060-$18,090 for a single
individual)
Average Medical Deductible In Plans with Separate Medical
and Prescription Drug Deductibles (2018)
Figure 5

7. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 39 states with Federally Facilitated or Partnership
exchanges in 2018 (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-2018/. 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.
$6,909
$5,442
$2,039
$970
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
Silver with no CSR:
Incomes over 250% of FPL
(over $30,150 for a single
individual)
Silver, CSR 73% AV:
Incomes 200%-250% of FPL
($24,120-$30,150 for a single
individual)
Silver, CSR 87% AV:
Incomes 150%-200% of FPL
($18,090-$24,120 for a single
individual)
Silver, CSR 94% AV:
Incomes 100%-150% of FPL
($12,060-$18,090 for a single
individual)
Average Out-Of-Pocket Limit In Plans with Combined Limit for
Medical and Prescription Drug Cost Sharing (2018)
Figure 6