As with so much else in healthcare, the answer is “it depends.” What it depends on are which state you live in, your income, the number of people in your family (if you elect family coverage), whether you pick a Bronze, Silver, or Gold plan, and the specific plan that you pick. Keeping all that in mind, the average 2017 Obamacare premium was $393 per month for individuals and $1,021 for families, before subsidies, with deductibles averaging $4,328 for individuals and $8,353 for families.
Depending on the size of the subsidy and the plan selected, the individual monthly premium can be as low as $50 per month. As with so many other government benefits that are based in part on income, the only way to know for sure is to apply for healthcare or get a health insurance quote.
Why Is There Such a Wide Variation in Cost?
First, there is a lot of variation from state to state, and within states. Healthcare is more expensive in New York City than it is in Cour d’Alene, Idaho. Second, most plans try to enroll providers who are cost-effective. Some succeed better than others. Third, any plan that includes major university-associated medical centers is going to be more expensive than one that doesn’t. Fourth, plans have to make enough money to stay in business, and exactly how much money that is depends in large part on how old, and how sick, their enrollees are. Fifth, while all plans meet the minimum requirements set forth in the ACA (which are relatively generous compared to many pre-ACA plans), some cover much more than others.
Then there is the issue of “metal” – is the plan you picked Bronze, Silver, Gold, or Platinum?
Bronze plans expect to pay about 60% of your healthcare costs, Silver plans 70%, and Gold plans 80%. These percentages apply unless you are eligible for cost-sharing subsidies (different from the Obamacare premium subsidy), in which case the plan plus the subsidy will cover a bit more.
Prices rose steeply in the early years of the ACA because many plans severely underpriced their services and also enrolled people who were, on average, older and sicker than they expected. Now that the dust has settled, some premiums are actually reducing in price. Silver plans with a cost-sharing reduction subsidy pay 73, 87, or 94 percent of your healthcare costs.
How Much Will I Pay?
Both the premium subsidy and the cost-sharing reduction subsidy affects how much you actually pay for a premium and out-of-pocket. The premium subsidy is designed so that you never have to pay more than 10% of your income for an individual plan. To give an example, if your income is $40,000 and you select the second-lowest-cost Silver plan, which costs (hypothetically) $12,000, your premium subsidy will be $8000 ($12,000 minus $4000); you will pay $333.33 per month and the government will pay $666.67 per month. Premium subsidies are always based on the cost of the second-lowest cost Silver plan.
So, What’s My Plan?
As with so many government benefits, you will not know your definite costs until you actually apply. Get professional assistance choosing the plan that’s right for at HealthQuoteInfo.com or call 855-881-0430.