Jan 1st, 2014 has ushered in a new suite of health plans. It can be easy to get lost in the technical speak (actuarial value, etc) but we want to provide a clear introduction to the options so you can make a good choice. First, what are the metallic plans?
There are 4 main metallic types and each pertains to a certain level of health benefits. They all covered the same Essential Health Benefits but with different levels of cost sharing by the consumer. That's the key..as you go up the scale (Bronze, Silver, Gold, Platinum in that order), you will share less of health care costs than the lower plans but you will pay a higher premium to have this richer coverage.
We'll make this simple. The new plans must conform to a certain AV as listed:
Roughly speaking, the percentage is what the AVERAGE person can expect the carrier to pay of their health care costs with this particular plan. Platinum pays a lot more (90%). So how does this translate out to actual plans you can choose from?
Each carrier approved to offer coverage will have plan options at the different metallic levels. They have to design the plans to hit the AV numbers listed above (+/- 2). That doesn't mean the plans will all look the same. They can tweak certain parameters (deductible, max OOP, copays, co-insurance, drug benefits, formularies, doctor networks) to hit a certain metallic level and yet, look quite different. When you run your California Exchange health quote, you'll be able to sort by metallic but being able to see all the plans is critical. So which of these plan levels make the most sense?
If you're gross adjusted income is below 250% (see income grid here), it is in your interest to get a Silver plan. The Silver plan will not only be eligible for the subsidy but will also get the cost sharing benefit with income between 138% and 250%. This will essentially kick up your AV rating for the same cost as the standard Silver on a sliding scale (lower income = better benefits). If you make between 250% and 400%, you can choose any in-Exchange metallic plan for a subsidy (if eligible).
Choosing a metallic plan will rely on the same process we've always used. Check out our "Which health plan is right for me" article but here's the short cut:
There will be many different variables in
comparing the Metallic health plans so please
feel free to contact us at 800-320-6269 with your particular
situation. There is no cost to you and we pride
ourselves on helping people find the best value.
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!
YOU MAY STILL BE
ABLE TO ENROLL
In just 15 minutes:
With Existing Account
We can help you:
If Your Income
Is In This Range
Current Years Estimate; All those that file together on one 1040:
|Single Person:||$16k - $47k|
|2 People||$22k - $64k|
|3 People||$27k - $80k|
|4 People||$33k - $97k|
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