Who would be a good candidate for a silver plan in the health insurance marketplace?
Asked by: Veronica Wyman II | Last update: December 25, 2022Score: 4.5/5 (47 votes)
This is one of the most important reasons to pick a silver plan. If your income doesn't exceed 250% of the poverty level (and particularly if it doesn't exceed 200% of the poverty level, as CSR benefits are strongest below that level), a silver plan with CSR benefits will likely be the best value for you.
Who should get a Silver plan?
The Silver Plan is best-suited for: An individual or family who mainly goes in for doctor visits, lab work or x-rays, or who takes generic drugs. Someone who is relatively health. An individual or family who wants reasonable copayments for common services.
Why are Silver plans better?
Silver plans fall about in the middle: You pay moderate monthly premiums and moderate costs when you need care. Important: If you qualify for “cost sharing reductions” (or “extra savings”) you can save a lot of money on deductibles, copayments, and coinsurance when you get care — but only if you pick a Silver plan.
Should I get Silver health plan?
A Silver health plan is a good choice for many people, because it balances premium and out of pocket medical costs. However, if you are young, do not anticipate using insurance often and have significant amounts of cash in savings, you may find that you save money with a Bronze or catastrophic plan.
What are Silver plans?
A silver plan pays for more out-of-pocket medical costs than a bronze or catastrophic policy but less than a gold or platinum plan. Each company selling health insurance in a Marketplace must offer at least one silver-level plan. Silver plans pay, on average, 70% of the cost for the benefits that the plan covers.
Choosing Bronze, Silver, Gold, or Platinum Health Plans NEW
How much does the Silver plan cost?
The average monthly non-subsidized health insurance premium for one person on a benchmark plan (i.e., “Silver” plan) was $450 per month in 2021. Monthly premiums for ACA Marketplace plans vary by state and can be reduced by subsidies.
Why should consumers look closely at Silver level health insurance plans?
Why should I look closely at the Silver level plans? If you have household taxable income that is less than 250% of the federal poverty level (“FPL”), you can get extra financial help (known as “cost-‐sharing reductions”). But you can get that help only if you buy a Silver plan through your state's Marketplace.
Which is better silver or bronze?
Bronze plans: lower monthly payments, but higher out-of-pocket costs. Silver plans: monthly payments lower than a gold plan, but more than bronze. Your out-of-pocket costs will be less than a bronze plan, but more than a gold plan, unless you're eligible for cost sharing reduction.
How do I qualify for a silver 94 plan?
To qualify, you must sign up through Covered California. Also, you must meet Covered California income requirements. Eligibility is determined using your family income, household size, age, and where you live. Generally, you may qualify if your income is just above 138% to 150% of the Federal Poverty Level.
What is the deductible for silver plan?
The Silver 70 Plan has a mid-sized deductible of $2,500 per individual or $5,000 for a family. This applies to benefits such as hospitalization, and ambulance services. This means that if you go in for a service that is subject to the deductible, you pay the first $2,500/$5,000, then, the insurance kicks in.
What is a good deductible for health insurance?
Any health plan carrying a deductible of at least $1,400 for an individual or $2,800 for a family. Total out-of-pocket expenses for the year can't exceed $7,050 for an individual or $14,100 for a family, including deductibles, copayments and coinsurance.
Which plan has the highest out-of-pocket costs?
Health plans with very low insurance premiums — like a catastrophic plan or high-deductible health plan (HDHP) — tend to have higher out-of-pocket maximums.
Which metal plan will have the highest out-of-pocket costs?
Out-of-pocket maximum
The highest possible out-of-pocket limit for an individual in 2019 is $7,900, and for family plans it is $15,800. Your limit may be higher with a Bronze plan. Learn about your health insurance options.
How do you qualify for silver 73?
Typically, adults with an annual income of 200% to 250% of the Federal Poverty Level may be eligible for a Covered California Silver 73 Plan. Minors 18 and under do not qualify and more than likely will have the option to enroll on Medi-Cal or some people opt to enroll them on a full priced plan.
What is the difference between Kaiser silver and gold?
According to the Kaiser Family Foundation, the actuarial values for the four levels of coverage are: Bronze: 60 percent. Silver: 70 percent. Gold: 80 percent.
What is the difference between silver 94 and silver 87?
The Silver 73 covers 73% of your out-of-pocket costs, 3% more than the standard Silver Plan. However, if you qualify for a Silver 87 or a Silver 94, you will receive 87% or 94% coverage, which is 17% or 24% more of your out-of-pocket costs than the standard Silver Plan.
What is silver 94 health plan?
It's calculated as a percentage. For example, under a Silver 94 plan, you would pay 10 percent of the total cost of a wheelchair or oxygen tank after meeting your deductible, and your plan would pay for the remaining 90 percent.
Which metal plan has the highest monthly premium?
Platinum pans have the highest monthly premiums, and the lowest cost to you when you actually access care. They also have the lowest annual deductibles of all the metal tiers.
Is silver plan better than gold?
A Silver plan has an AV of roughly 70%, a Gold plan has an AV of roughly 80%, and a Platinum plan has an AV of roughly 90%. Within those constraints, the actual plan design can vary considerably, so it's possible to find a Gold plan that has a higher deductible than a Silver plan.
What plan has the highest monthly premium?
Platinum plans usually have the highest monthly premiums of any plan category but pay the most when you get medical care. They may work well if you expect to use a great deal of health care and would rather pay a higher premium and know nearly all other costs are covered.
How can consumers decide which metal tier health insurance plan is right for them?
When choosing a metal tier, first check if you qualify for premium tax credit or cost-sharing reductions. If so, it will help you figure out what you can afford in premiums or whether you need to choose a silver plan (to get a cost-sharing reduction subsidy). Next, consider your likely health needs in the year ahead.
Why are silver plans more expensive than gold?
That's because you qualify for additional discounts that will lower your deductible and co-payment, making a silver plan even more generous than a gold plan. Premium subsidies, which are unaffected by the president's actions, will protect you from premium price increases.
What does metal level mean?
Levels of plans in the Health Insurance Marketplace®: Bronze, Silver, Gold, and Platinum. Categories (sometimes called “metal levels”) are based on how you and your insurance plan split costs. Categories have nothing to do with quality of care. (“Catastrophic” plans are available to some people.)
What is the monthly second lowest cost silver plan?
The Benchmark Plan is the Second Lowest Cost Silver Plan available to the family through the state's health benefit exchange. Benchmark Plan costs vary based on the age of each enrollee at the time of enrollment or renewal. For 2021, the DC Health Link Benchmark Plan is the KP DC Standard Silver 4000/40/Vision plan.