Where every insurance premium dollar goes

For every premium dollar that is spent, 82.4 cents goes toward prescription drugs and medical expenses, according to a Sept. 6 report from America's Health Insurance Plans. 

The health insurer lobby and trade group analyzed data on where premium dollars were spent in the commercial marketplace from 2018 to 2020, according to a Sept. 6 AHIP news release. 

"This three-year trend data includes the first year of the COVID-19 pandemic, when healthcare utilization was down dramatically as patients deferred care and isolated due to the risk of infection," AHIP President and CEO Matt Eyles said in the release. "If Americans are to experience lower premiums, we must improve competition among Big Pharma, hospitals and healthcare systems, and specialists. That is how we make coverage and care more affordable and accessible for everyone."

Here is where premium dollars are being spent:

  • Prescription drugs: 22 cents 
  • Outpatient hospital costs: 19.9 cents 
  • In-patient hospital costs: 19 cents
  • Doctor visits: 11.8 cents
  • Other outpatient care: 6.2 cents
  • Other administrative expenses: 4.2 cents 
  • Taxes and fees: 3.8 cents 
  • Profit: 3.6 cents 
  • Emergency room costs: 3.3 cents 
  • Other fees and business expenses: 3 cents 
  • Cost containment: 2.1 cents 
  • Quality improvement: 0.8 cents 

Read the full report here

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