No matter if it’s your first experience purchasing health insurance (#adulting), losing employer-provided coverage or retiring early; knowing the cost of individual policies is vitally important.
Premium costs vary widely based on factors like your age and location. Thanks to the Affordable Care Act (ACA), gender or preexisting conditions no longer play an impactful role when it comes to setting premium costs.
Bronze plans offer lower monthly premiums but higher out-of-pocket expenses; their average medical deductible for single persons stands at $4,500 while for families it can exceed $9,000.
Consider selecting a Bronze plan if you don’t anticipate needing significant healthcare and are seeking an economical way to meet the individual mandate. However, be aware that any time an injury arises or medication is prescribed you’ll likely pay full price until reaching your deductible amount.
Expanded Bronze Plans enable you to pay fair prices for certain essential health benefits even before reaching your deductible, making them an appealing option for those comfortable with higher deductibles but wanting additional robust coverage to satisfy the individual mandate.
Silver plans generally cost less per month than Bronze plans but more than Gold plans unless you qualify for premium tax credit subsidy. Your out-of-pocket expenses depend on what services you utilize; for instance, if you sustain a head injury playing flag football and visit the emergency room as a result, those costs could become prohibitive even with a Silver plan in place.
Silver plans are like the minivan of metal tier plans: With moderate monthly payments (premiums) and reduced healthcare costs when you need care, as well as potential cost-sharing reductions that may help save even more on deductibles, copayments and coinsurance premiums.
The gold plan is an option for individuals looking for reduced out-of-pocket expenses when using their health insurance plan. While all plans may have the same actuarial value, each may come with different deductibles, copays, and coinsurance costs that will differ based on which policyholder chooses it.
Consider that gold-tier plans tend to offer higher out-of-pocket limits than Bronze and Silver plans, meaning that they typically cover more of your medical expenses, though it’s still important to budget properly.
Overall, making the right decision requires considering your willingness to pay on a monthly basis for less costly healthcare services when they become necessary. Keep in mind that qualifying individuals or families who purchase Silver plans during either Open Enrollment Periods or Special Enrollment Periods could even qualify for premium tax credits!
Platinum plans tend to have lower deductibles and copayments than their metal tier counterparts, and in 2023 are projected to have the lowest average monthly premium due to record affordability and premium tax credits. But keep in mind that an actuarial value indicates how many of your medical costs the plan will cover for an average person – your individual costs could differ substantially.
Each plan tier provides you with a maximum payment in any given year before your insurance company begins covering 100% of in-network care services. A Bronze plan usually offers higher maximum limits, while Platinum usually offers the least. If you anticipate using health care services frequently, selecting either Silver or Gold plans could save money overall on annual costs.