Agency News and Notes

Hospital copayments are required of more workers

The percentage of workers enrolled in health plans sponsored by private-sector employers that obligated them to pay a share of their hospital bill increased by more than 60 percent between 1999 and 2003—from 33.8 percent to 54.7 percent—according to data from AHRQ's Medical Expenditure Panel Survey (MEPS). The percentage of enrolled workers whose plans did not require hospital copayments fell by nearly a third between 1999 and 2003—from 66.3 percent to 45.3 percent. The percentage whose plans required copayments ranging from $150 to $400 for hospital care doubled from 10.5 percent to 21 percent during the same period, as did the percentage of those required to pay more than $400 (from 6.4 percent to 13.1 percent).

MEPS data also showed that the proportion of enrolled workers required to make a copayment when they visited the doctor increased only slightly—from 92.4 percent to 95.3 percent—but there were more dramatic shifts in the amounts they had to pay. The percentage that had to pay more than $0 but less than $10 per physician visit shrank from 57 percent to 23.5 percent and the proportion that had to pay more than $10 but less than $20 per physician visit almost doubled, rising from 33.4 percent to 60.8 percent between 1999 and 2003. The 2 percent of enrolled workers who had to pay more than $20 per visit ballooned to 11 percent in 2003.

For further details see Changes in Co-pays for Employer-Sponsored Health Insurance Plans, 1999-2003 at http://www.meps.ahrq.gov/mepsweb/data_files/publications/st127/stat127.pdf [PDF Help]. For a related MEPS Statistical Brief, see Changes in Out-of-Pocket Maximum Limits for Employer-Sponsored Health Insurance Plans, 1999-2003 http://www.meps.ahrq.gov/mepsweb/data_files/publications/st128/stat128.pdf [PDF Help].

Return to Contents
Proceed to Next Article