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- Obamacare Plans provide premium subsidies to lower the monthly costs.
- Obamacare Silver Plans have payment assistance that reduce the costs of health insurance.
- Federal and state agencies review and approve the prices and terms of Obamacare plans to hold down prices.
- The Affordable Care Act mandatory insurance provision holds down prices by expanding participation.
- Medicaid expansion and Children’s Health Insurance do not require additional payment.
- Children age 26 and under can stay on a parent’s Obamacare insurance policy.
The costs of Obamacare health insurance depend on the type of plan selected and the income level of the insured individual. Premium subsidies and payment assistance lower the costs. Comparison shopping can further reduce costs while improving value. Start comparing health insurance rates now by using our FREE tool above!
The Obamacare marketplace
The insurance purchasing system under Obamacare is a system of state and federal marketplaces for health insurance plans. The federal and state governments operate the exchanges and must approve all plans prior to sale on these websites. All plans must meet the requirements of the ACA. They must be qualified health plans that offer the best combination of coverage, low deductibles, and favorable out of pocket expenses. There is a reverse relationship between premiums and out of pocket costs; low premiums generally require higher deductibles and larger out of pocket costs.
Insurers present the costs and coverage in Obamacare approved plans during the Open Enrollment. For 2016, the Open Enrollment runs from November 1, 2015 through January 31, 2016. Comparison shopping can reduce the costs of health insurance by finding the plans with low costs and high value to the individual or family. Plans have a higher value when they match the needs of the individual or family as closely as possible.
Subsidies and Financial Assistance
Obamacare offers premium subsidies based on income and payment assistance for Silver plans. Annual income is the basis for determining eligibility for subsidies and assistance. No one can get assistance if their annual income is higher than 400 percent of the federal poverty guidelines. The guidelines provide figures for families and individuals. The amount of subsidy decreases to zero as income approaches the 400percent threshold.
The Open Enrollment is a time to change plans inside the Obamacare marketplaces. Changing plans can reduce the costs of insurance particularly if it results in greater subsidy or payment assistance.
Changing plans can improve value to the consumer.
Some plans renew automatically. If consumers do nothing during Open Enrollment, they may receive notice of automatic renewal. Open Enrollment is the period in which insurers introduce new plans. Consumers can learn about their options by reviewing new plans during Open Enrollment.
Prices are the Same
When shopping for plans, consumers can use insurance agents and go directly to insurance providers to research, compare, and select policies. The prices for identical policies will be the same whether purchased on or off the exchange. The difference is that plans purchased off-exchange cannot receive premium subsidies or payment assistance.
Rating Obamacare Plans
Obamacare uses a system of actuarial value to rate plans approved for the federal and state marketplaces. All plans must score 60 percent or higher, and the approximate value ranks are the basis for the designation in the system of metal bands. The platinum, gold, silver and bronze groupings help consumers compare plans with similar levels of coverage and consumer costs.
The Metal Bands
Insurers presented plans for approval to federal and state marketplaces. They had with various percentages of insurance paid coverage versus consumer paid coverage. Within these broad similarities are some important differences such as restrictions in facilities and specialists and out of network resources. Consumers must look far beyond price and premiums to decide which plan is best. The four types of plans available through Obamacare are described in the itemized list below.
- Platinum Plans cover about 90 percent of plan costs leaving ten percent to the consumer; these plans have the highest premiums and lowest out of pocket costs.
- Gold Plans pay about 80 percent of plan costs and have high premiums, lower deductibles and out of pocket costs than Bronze or Silver Plans.
- Silver Plans cover about 70 percent of costs and persons with incomes below 250 percent of the federal poverty guideline amount can get payment assistance through Obamacare marketplaces.
- Bronze Plans pay about sixty percent of plan costs. This category has the lowest premiums and high deductible thresholds, and out of pocket costs.
Medicaid expansion was part of the health care reform meant to close the gap between the minimum income for health plans and the maximum income for Medicaid. By expansion, no one would be left without affordable coverage. Many governors rejected the protection for their most vulnerable citizens and left them without free or low-cost coverage. The ACA expanded Medicaid because it covered severe, chronic and life-threatening conditions like diabetes and heart conditions.
Low-Income Children’s Coverage
The Affordable Care Act extended the Children’s Insurance Programs or CHIPs. Persons who are not eligible for Obamacare plans because they earn too little to qualify are automatically referred for assessment in Medicaid and CHIPs..
Shopping Outside of the Marketplace
The Obamacare marketplace consists of Healthcare.gov and the state exchanges. Those who make more per year than 400 percent of the poverty line for individuals or families cannot get subsidies or financial assistance. They should search the entire market. Ultimately, they may find the best price and coverage in an Obamacare marketplace plan. They can select and buy policies in the Obamacare system without subsidies.
Compare for Best Price and Value
Comparison shopping is the best way to lower the costs of health insurance purchases through Obamacare or off the Obamacare marketplace. Persons near or over the 400 percent of federal poverty guideline amount should receive little or no subsidy or assistance, and need to get the widest possible range of qualified health plans. Many insurers offer qualified health insurance plans that are not available on the Obamacare exchanges. To get the full range of price and coverage options, persons that do not get subsidies should shop outside of Obamacare marketplaces. Start comparing health insurance rates now by entering your zip code in our FREE tool below!