How to Be a Smart Obamacare Shopper

The Trump administration’s actions to scale back Obamacarehave made it harder and more complicated to find the best health plan. But the pricing chaos has also created great deals for some consumers, who can sign up during open enrollment beginning today. Here’s our advice on how to shop — the best strategy depends on how much you earn.

If you qualify for big discounts on deductibles and co-payments, it’s probably best to stick to the cheapest silver plan.

If you earn below 200 percent of the federal poverty level, or about $24,000 for a single person, you can get lower out-of-pocket medical costs because the government pays insurers to give you discounts.

The Trump administration ended these subsidies, but the law requires that insurers still give the discounts to consumers. That means a silver plan is still going to be the best deal, since you will be able to get a rich set of benefits for a fraction of your income.

While premiums have risen over all, there are still many places where the cost of the least expensive silver plan will cost less for people like you, according to data from the Kaiser Family Foundation.

Change in price of lowest-cost silver plan after subsidies for a 40-year-old earning $20,000, 2017 to 2018

Less expensive

than 2017

More expensive

ME.

MONT.

N.D.

ORE.

N.H.

WIS.

S.D.

R.I.

MICH.

WYO.

PA.

IOWA

N.J.

NEB.

NEV.

OHIO

DEL.

UTAH

IND.

ILL.

W.VA.

VA.

KAN.

MO.

KY.

N.C.

TENN.

OKLA.

ARIZ.

ARK.

S.C.

N.M.

ALA.

GA.

MISS.

LA.

TEX.

FLA.

ALASKA

HAWAII

Source: Kaiser Family Foundation | Note: Map looks at states that sell health plans through the federal HealthCare.gov website. Information about the remaining states will be made public in November.

It’s worth looking at the different silver options to see which ones cover the doctors and hospitals you care about.

If you get premium subsidies but not big discounts, you may be better off with a gold or bronze plan.

If you earn between 200 percent and 400 percent of the poverty level, about $24,000 to $48,000 for a single person, you qualify for help paying your premiums from the federal government.

Because most states are increasing prices on silver plans, which are used to calculate your subsidy, you are likely to have more buying power this year if you want to buy a gold plan, with a lower deductible. In the past, the cheapest gold plans have always cost more than the cheapest silvers.

Where gold is cheaper than silver for a 40-year-old earning $30,000, after premium subsidies

WIS.

WYO.

MICH.

PA.

N.J.

KAN.

N.M.

GA.

TEX.

Source: Kaiser Family Foundation | Note: Map looks at states that sell health plans through the federal HealthCare.gov website. Information about the remaining states will be made public in November.

You may also be able to use your enhanced subsidy to buy a free high-deductible bronze plan. (If you do, you may want to sock away some of your savings, so you can pay that deductible if you have a big medical emergency.)

Where a bronze plan is free for a 40-year-old earning $30,000, after premium subsidies

ME.

WIS.

WYO.

PA.

NEB.

UTAH

ILL.

VA.

MO.

N.C.

TENN.

OKLA.

ARIZ.

S.C.

GA.

ALA.

TEX.

FLA.

ALASKA

Source: Kaiser Family Foundation | Note: Map looks at states that sell health plans through the federal HealthCare.gov website. Information about the remaining states will be made public in November.

If you are older than 40 or earn less than $30,000, there may be even more places where you can find a free bronze plan.

Even if you are not in a place where you can benefit from a cheaper gold or free bronze plan, the law’s subsidy structure still protects you from price increases. Indeed, many people who buy the least expensive silver plans for 2018 will pay less out of pocket than they did this year.

If you don’t get any government subsidies, you are probably better off looking outside the Obamacare marketplace.

If you make over 400 percent of the federal poverty level, or about $48,000 for a single person, you can’t collect a subsidy, and you’re on the hook for the whole price of your coverage.

But in many states, though not all, there will be silver plans you can buy directly from an insurer that will cost less than the plans that are sold on the Obamacare marketplace. A human or online broker can help you explore all those options.

Look at the example below, to get a sense of the better deals you may be able to find outside the state exchange.

Average monthly premium for a 40-year-old in Scranton, Pa., without subsidies

CATASTROPHIC

BRONZE

GOLD

SILVER

On and off exchange

SILVER

Off exchange only

0

$100

$200

$300

$400

$500

$600

Source: Pennsylvania Insurance Department

If you have Obamacare coverage this year, don’t just renew your coverage without exploring all your options.

This is such an odd year for price increases that switching may get you better coverage for less money. Even if you like your plan, you should make sure it remains the best choice for you.

The last day to enroll for coverage is Dec. 15 in most states.

About masterkan

Louis Sheehan
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