This diary is a continuation of my last diary “Obamacare Tax Credits In One Easy Chart” here:
Bronze plans will pay on average 60% of covered costs, while the enrollee pays 40% up to a certain maximum per year, which for 2014 is $6,350 per individual and $12,700 per family (or even less for lower incomes — see below). Silver plans have a 70/30 split; Gold 80/20; and Platinum 90/10. The Bronze plan will have the lowest premium and highest cost sharing; vice-versa for a Platinum plan. Note that these are averages for the population that has that metal tier, not for you individually. That’s what that wonky term “actuarial value” means.
Depending on how much healthcare you anticipate using, you can opt to pay a higher premium for a Gold or Platinum plan, or a lower premium for a Bronze plan. Whatever you choose, the amount of the federal tax subsidy will be based on the premium for the second lowest Silver plan offered in your state’s exchange. You can apply that subsidy amount toward the plan tier of your choice.
100% to 150% FPL: 94% / 6%What’s more, the maximum annual out-of-pocket (excluding premiums) for lower incomes are reduced below the standard annual max of $6,350 per individual and $12,700 per family:
(plan and govt pay 94% of covered costs on avg; consumer pays 6%)
150% to 200% FPL: 87% / 13%
(plan and govt pay 87% of covered costs on avg; consumer pays 13%)
200% to 250% FPL: 73% / 27%
(plan and govt pay 73% of covered costs on avg; consumer pays 27%)
100% to 200% FPL: Annual max of $2,250 per individual and $4,500 per familyYoung adults under age 30 will also have the option to purchase a catastrophic plan for even lower premiums (but higher cost sharing if you get sick). Because these plans will have the lowest premiums, no tax credits are available on catastrophic plans.
200% to 250% FPL: Annual max of $5,200 per individual and $10,400 per family
My prediction is folks are going to have way more choices than they may want to sort through. Fortunately, there will be trained navigators, certified application counselors, and a 24/7 consumer line 1-800-318-2596 to help. Ahhh.... so many choices, so much freedom if you don’t suffer from analysis paralysis!
You can also check out California’s nifty state-run Marketplace to see how yours might look:
Just type in a California zip code to interact with it. The site is very user-friendly with easy comparison shopping of plans, costs, and tax credits.