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Many people with expensive chronic health conditions are eagerly looking forward to Obamacare. But the plan that actually has the lowest out-of-pocket deductibles may not be the Platinum or even Gold Plan.
Four Tiers of Coverage
When you go to sign up for new health insurance at one of the state health insurance exchanges or, when it finally is up and running, the national health insurance exchange (if you live in a state whose governor or legislature has rejected the expansion of Medicaid to the working poor), the first thing you will be asked is where you would prefer a Platinum, Gold, Silver, or Bronze plan.
The difference among the four plans is the deductibles.
- With a Bronze Plan, the plan pays 60% of your health expenses, and you pay 40%, but you pay the lowest available monthly premium.
- With a Silver Plan, the plan pays 70% of your health expenses and you pay 30%, but you pay only a slightly higher monthly premium.
- With a Gold Plan, the plan pays 80% of your health expenses and you pay 20%, but you pay a significantly higher premium.
- With a Platinum plan, the plan pays 90% of your health expenses and you pay 10%, but you pay the highest premium.
After you choose a Bronze, Silver, Gold, or Platinum plan, you will then be asked the brand you prefer (Blue Cross, Cigna, Kaiser, etc.) and next the type of plan, such as HMO, PPO, POS, or health savings account.
Tax Credits May Cover Part of Premiums
When you have made all your choices, the system will tell you what your monthly premium will be. However, there are at least two breaks in medical costs.
One of these breaks is a tax credit against the cost of the premiums. This is a lump-sum payment to the insurance company that covers all or part of your monthly premium costs.
Single people who earn up to about $46,000 a year qualify for credit. (In states with governors and legislatures that have accepted Medicare expansion, all of them with Democratic party officials in power, single people who earn $15,000 or less per year will get their coverage for free. In about 22 other states, all of them with Republican party official in power, people not now on Medicaid who earn $15,000 or less will get no coverage at all.)
Families of four that earn up to $92,000 per year will also qualify for credit.