Health Subsidy And
The Exchange Plans
We have had two decade of health insurance
experience and the health reform changes still
require a great deal of study to understand.
We can imagine how it must feel for the average
American who is trying to see how it applies to
them. There's a host of new terms with
critical impact on how much you will pay for health
insurance. One of these is Health Exchange.
Let's understand what exactly the Health Exchange is
and how it affects your options for a health
First, what is the Health
The Health Exchange is a marketplace to buy
specific health plans starting
Jan 1st, 2014.
These are referred to as Exchange Plans and they are
also called the Metallic health plans. There
will be a Bronze, Silver, Gold, and Platinum with a
Catastrophic option for younger people. There
will also be other plans outside of the Exchange and
we'll discuss how these might be different.
You will be able to quote both Exchange plans and
non-Exchange plans through our
Health Subsidy Quote
page once they're available (Oct 1st, 2013).
This is ideal since the Exchange will only be able to
quote plans inside it which may or may not be the
best value for you. What will dictate this?
Subsidies will form the dividing
line for Exchange Plans
If you make less than 400% of poverty (the
Rule), it will be hard to beat the eligible Exchange
plans since you will likely qualify for a health
subsidy which is after all, the whole point of this
entire website. It's potentially a lot of
money at state...$1000's of dollars per year for
most people. Your
page will automatically determine if you qualify for
a health subsidy and towards which plan at no cost
to you. Only the qualified Exchange plans will be eligible for a subsidy
so that will narrow your decision making down
considerably since the the total premium will
probably be subsidized by 50-80% depending on your
income level. This will outweigh any other
plans/rate differences that might occur in most
situations. What if you don't make under 400%
of the Federal Poverty Level? Do the Exchange
Plans still make sense?
Differences between Exchange and
The first consideration will be whether you have
a Grandfathered health plan. We've discussed this
consideration in depth at our
versus Exchange plan page. It's important to
understand how that works. If you have a
non-Grandfathered health plan, there may be
advantages to non-Exchange health plans. We're
starting to see a blueprint for non-Exchange health
plans with much larger doctor/hospital networks than
Exchange plans. The core benefits for
non-Exchange plans have to match the Exchange plans
but the in-network doctor networks may be half the
size of current networks inside the Exchange.
This could be a big deal. The costs will
likely be the same but if you want the better
doctors/hospitals, non-Exchange plans might be the
way to go. Again, you'll be able to quote both
Exchange health plans and Non-Exchange health plans
through our Health Plan Quote page when they're
available October 1st, 2013.
Metallic Health Plans
Silver health plan
Los Angeles, Family of 4
Adult making $30K
on age, expected costs, and other assumptions
according to Kaiser Calculator. Actual
subsidies will vary and official subsidy amounts
will be available Oct 1st, 2013.