Buzz
The year 2017 has been an unusual time for health insurance purchases. Despite several unexpected and negative developments that might suggest rising costs, many people are now finding insurance plans becoming more affordable due to an unexpected twist.
The reason behind this shift lies in some government actions related to CSR payments, which have driven up the costs of silver plans significantly. However, subsidies provided by the government to assist low and middle-income families are tied to the price of these silver plans. As a result, the subsidies have also increased substantially.
For those eligible for subsidies, the out-of-pocket cost for a silver plan remains similar to last year. However, this also opens the opportunity to opt for a more economical bronze plan. Many individuals may find that the subsidies are so substantial that they can secure a bronze plan at no cost.
According to The Wall Street Journal, a 60-year-old earning $36,000 annually could access a zero-premium plan in over half of the country’s counties. Even with an income of $48,000, a 60-year-old could still qualify for zero-premium insurance in more than 600 counties. In California, approximately half a million people might only need to pay the state’s minimum fee of $1 per month.
Even if you don’t secure an exceptionally good deal, many individuals will still find affordable options. For instance, last year, 71% of exchange users could obtain a plan for under $75 per month. This year, as per a federal government report, that figure has risen to 80%. In certain states, such as Alabama, over 90% of shoppers on the exchanges can find plans priced at $75 or less.
How can I determine if I’m eligible for this deal?
If you’re a single individual earning $48,240 or less annually and lack employer-based health insurance, you likely qualify for subsidies. (For households with more than one person, the threshold varies: $98,000 for a family of four, with additional details available here.)
Even if you didn’t qualify for subsidies previously, it’s worth revisiting your eligibility. Annual changes, such as adjustments to the federal poverty level and fluctuations in your income, age, or family size, can impact your qualification. Additionally, the insurance plans offered in your area may also change each year.
While we can’t provide a definitive answer, you can visit healthcare.gov to calculate your eligibility. Use this calculator to determine if you qualify for a subsidy based on your adjusted gross income, and then preview plans to see actual pricing. (Note: Some states operate their own exchanges, so while the subsidy calculator applies, you’ll need to visit your state’s website for plan details.)
Special Cases
Under no circumstances should you allow yourself to be automatically enrolled.
Given the complexities of this year’s healthcare landscape, I consulted Charles Gaba, the expert behind acasignups.net, who monitors insurance pricing and exchange enrollments. He emphasized, “No matter what, avoid automatic enrollment.” This occurs if you fail to select a plan, often resulting in a plan similar to your previous one. However, this year’s unpredictability makes it crucial to explore your options thoroughly.
Gaba also highlighted scenarios where finding affordable insurance might prove more challenging:
If you don’t qualify for a subsidy, the inflated silver plan prices won’t benefit you. Instead, you’ll face higher costs. Consider switching to a bronze plan (lower premiums but higher deductibles) or a gold plan, which offers better coverage at a higher price. Interestingly, gold plan premiums may be more affordable than the exorbitant silver plan rates this year.
If you don’t qualify for a subsidy and reside in Alabama, California, Connecticut, Florida, Hawaii, Illinois, Idaho, Maine, Maryland, Minnesota, Nevada, Ohio, Pennsylvania, Rhode Island, South Carolina, Utah, Virginia, Washington, Wisconsin, or Wyoming, there’s a unique opportunity for you. If a silver plan seems unaffordable, check if the insurer offers the same plan off the exchange. In these states, insurers can provide off-exchange plans at significantly lower costs.
In Colorado, Delaware, Indiana, Oklahoma, and West Virginia, the additional costs typically added to silver plans are distributed across all plans. Whether you qualify for subsidies or not, switching plans may not yield substantial savings.
Always compare prices. Your specific circumstances may present unique loopholes or challenges worth exploring.
Avoid assuming insurance costs are prohibitive; instead, calculate the figures to discover what’s truly affordable.
