Which Obamacare Plan is Right for Me?
IThough only you can determine which Obamacare plan is truly right for you, ObamacareUSA.org is here to help. We not only provide you with all the
information you need to make the right choice, but our partnerships and technology will show you the best plan options for your unique needs.
There are five types of Obamacare Plans. The first four are known as the “Metal Tiers” - which are Bronze, Silver, Gold, and Platinum. The last type is the “Catastrophic Plan,” which is a very low cost and limited plan meant to guard against worst-case medical scenarios.
Any one of these five plans will provide you with the peace of mind of having medical coverage. Before Obamacare, insurers could deny you coverage if you had preexisting conditions. They could also drop you if you became too expensive to insure. In other words, those who needed insurance the most could not get it! Now, by law, you can get and keep you coverage no matter what your medical condition.
Please note that the quality of coverage is also the same across each plan. This means that no matter what type of plan you have, you will be given the same level of care and medical treatment. With that said, once your eligibility is determined, choosing a plan all comes down to cost and how often you think you will need medical services.
What do the Metal Plans Cost and Cover?
The plans cover everything from preventive to emergency services and essentially everything in between. Specifically, the Affordable Care Act outlined 10 Essential Health Benefits that people universally need. You can learn more about the Essential Health Benefits here
The main differences among the plans have to do with how much you pay. Out of the four Metal Tiers, Bronze Plans have the lowest premiums or
monthly/yearly costs. The catch is that you end up paying more for out-of-pocket medical costs. If you think you will need little to no medical care, the Bronze Plan is probably not the best value for you.
A Platinum Plan is just the opposite. Your monthly rates will be much higher versus the Bronze, but you will pay a lot less out-of-pocket for medical services. Those who have medical conditions that need ongoing treatment typically find the Platinum Plan the most cost effective.
What plan do most people choose? According to the Department of Health and Human Services, the Silver Plan is the most popular. Over 62 percent chose a Silver plan during the Open Enrollment Period that began in 2013**.
For any of the four metal plans, if you have a low income, you can get a discount or credit on your monthly premiums. The credit is known as a “subsidy.” Learn more about subsidy qualifications here
Catastrophic Plans
The fifth coverage type is the Catastrophic Plan. These plans are designed to mainly provide you with coverage during a worst-case scenario, like a bad
accident or severe illness. Though they typically carry the cheapest premiums, you have to pay your entire deductible first before the plan starts paying for the cost of the serious medical event. However, preventive care and visits to your primary care doctor are deductible-free. But you are limited to only three primary care visits per year.
Note that Catastrophic Plans are excluded from Obamacare subsidies because they are already greatly discounted. These plans are only available to people under the age of 30. If you are over the age of 30, you can still get this plan if you meet one of the below hardships:
- Homelessness.
- Eviction or foreclosure.
- Utilities have been shut off.
- Victims of domestic violence.
- Death of close family member.
- Victim of natural disaster.
- Bankruptcy filing in past six months.
- Excessive medical debt.
- Financial hardship due to caring for a family member who is disabled, ill or elderly.
- Ineligible for Medicaid because the state where you live did not expand eligibility under Obamacare.
- Individual insurance plan was cancelled and you cannot afford an Obamacare Plan.
Comparing Plans
Depending on your eligibility, all five types of plans have their pros and cons. With ObamacareUSA.org, we will present you with the best rates and only the plans that meet your specific needs based on the information you give us. For a quick summary of the five different coverage types, please take a look at the table below:
Plan Type
% Medical Costs Paid by Your Plan
% Medical Costs Paid Out of Pocket
Subsidy / Tax Credit Can Be Applied If You Qualify?
Monthly / Yearly Rate
Recommended if You:
Bronze:
60%
40%
Yes
Low
Rarely see your doctor and rarely take prescription medication.
Silver:
70%
30%
Yes
Medium
Sometimes see your doctor and sometimes take prescription medication.
Gold:
80%
20%
Yes
High
Regularly see your doctor and regularly take prescription medication.
Platinum:
90%
10%
Yes
Premium
Frequently see your doctor and take multiple prescription medication.
Catastrophic (available only if you’re under 30 or have a hardship exemption):
Less than 60%:
More than 40%
No (Already priced low)
Lowest
Meet the plan’s eligibility requirements. The plan will protect you from worst-case medical scenarios, like serious accidents and illnesses. You must pay your entire deductible first before the plan pays for these worst-case medical scenarios. However, preventive care and 3 primary care visits per year are deductible-free.
