U.S. workers' OOP maximum for single coverage, 2009-2024
In 2023, 67 percent of employees on single coverage plans had an out-of-pocket (OOP) maximum of over 3,000 U.S. dollars. This means they had to pay a maximum of over 3,000 U.S. dollars a year (including deductibles and copayment/coinsurance) before their insurance paid for all other health costs.
The Affordable Care Act (ACA) requires that non-grandfathered health plans have an out-of-pocket maximum of no more than 9,450 U.S. dollars for single coverage and 18,900 U.S. dollars for family coverage in 2023. Just two percent of the surveyed workers with single coverage had an OOP maximum of more than 9,100 U.S. dollars. This statistic illustrates the percentage of workers in a single coverage insurance plan with an OOP maximum above select thresholds in the United States from 2009 to 2024.
