$2,907

$4,000

 
 

$5,200

January

February

 
 

September

January

$2,907

In her first month of coverage, Rebecca is responsible for $183 for her premium, $278 in out-of-pocket expenses for required trips to doctor, and $2,446 to pay for her needed medicines.

February

$4,000

Rebecca meets her deductible in February, however is still responsible for her premium and out-of-pocket costs until then. 

September

$5,200

Rebecca meets her maximum out-of-pocket limit in September.

January

$2,907

In her first month of coverage, Rebecca is responsible for $183 for her premium, $278 in out-of-pocket expenses for required trips to doctor, and $2,446 to pay for her needed medicines.

February

$4,000

Rebecca meets her deductible in February, however is still responsible for her premium and out-of-pocket costs until then. 

September

$5,200

Rebecca meets her maximum out-of-pocket limit in September.

Patient Profile: Out-of-Pocket Cost Burden

Rheumatoid Arthritis

Rebecca is a 53-year-old woman living in Florida. She makes 240% above the federal poverty level (FPL) at her job as a daycare worker. Rebecca also suffers from rheumatoid arthritis. To help manage her illness, Rebecca enrolled in a Silver plan through the Health Insurance Exchanges, and qualifies for some additional cost-sharing subsidies based on her income.

Scroll through the content below to engage with different stages of Rebecca’s health care story or download the PDF here.

Name: Rebecca

Age: 53

Location: Florida

Job: Daycare Worker

Income: $2,334 per month

Rebecca does qualify for additional cost-sharing subsidies

Condition: Rheumatoid Arthritis

Health Coverage: Health Insurance Exchange Silver Plan

Medications:
Brand-Name Tumor Necrosis Factor Blocker, Several Generics

Additional Symptoms:
Depression, High Cholesterol And Hypertension

Monthly Premium: $183 for Silver plan (After subsidies)

Deductible: $4,000

Out of pocket costs (in first month alone): $2,907

Total Costs of Health Care During the Year: 82% Of Total Income

Total Costs on Premiums and Health Expenses During the Year: 82% Of Total Income

The high out-of-pocket costs required by many exchange plans – even for someone getting additional cost sharing subsidies – can create major hurdles to acceptable health care access. Explore AccessBetterCoverage.org to learn more about coverage. 

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