Health Subsidies and the Exchange

It's very important to make sure you get the full health subsidy that you may be eligible for.  Yes, eligibility depends on income but the plan you choose and where you purchase the health plan also affects your ability to receive the subsidy.  We've discussed what is required to qualify based on income and we also discussed the requirement of the Silver plan but what about where you purchase your health plan?  Does that matter?  Yes!  Let's discuss the role of the Health Exchange in receiving your health subsidy.

Introducing the Health Exchange

There will essentially be two markets for health insurance on the individual/family and group markes.  THere will be a designated Health Exchange either ran by the State of Federal government and plans outside this Exchange or non-Exchange plans as they're described.  There may even be private Exchanges but these are different than the one government Exchange available in any given State.  Interestingly, if a carrier offers health plans in the Exchange, they must offer the same plans out of the Exchange at the same rate and vice versa.  So what are the benefits to purchasing in or out of the Exchange?

Subsidies reside in the Exchange

Health subsidies will only be available in the State of Federally sponsored exchange and cost sharing benefits will only be on the Silver equivalent plan.  This will be the primary driver to purchasing health insurance in the Exchange.  Although the non-exchange plans will have the same basic rates and benefits, they will likely additional add-ons and expanded doctor/hospital networks.  With health insurance rates expected to jump significantly, the health subsidies will become the most significant consideration to which plan you purchase and where you purchase it.  We are able to quote the best rates and quotes for both Exchange plans (with health subsidies calculated after Oct 1st, 2013) through our quoting page.  The first step of the quoting engine will be to determine if you might qualify for subsidies based on income and family make up questions.  Based on your answers, the system will be able to show you Exchange plans with subsidies calculated right into the proposed quote or non-Exchange plans without a subsidy but with benefits afforded (such as expanded provider networks).  Once the new rates are available online (October 1st), this will be the easiest way to find your most affordable options.

Health Exchanges can only show you half the picture

If you qualify for a health subsidy, it's hard to argue against an Exchange Silver plan.  The amounts we're talking about are too high to consider not going that route.  We're looking at 1000's of dollars in subsidized premium if you qualify.  For many people, even the idea of restricted network cannot offset this savings.  For those that do not qualify or who would like to see all the options, keep in mind that the Exchanges cannot show you the non-Exchange health plans.  It doesn't make sense to only see half the plans when you can use our quoting engine to see both sides and then choose what's in your best interests.  There is no cost for this service to you. 


Los Angeles, Family of 4
making $60K.

Iowa, Single Adult making $30K

*Based 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. 

Health Subsidy Calculator



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