Health Care

How Do I Shop For an Obamacare Health Plan?

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Start at your state's online insurance marketplace.

Log on to healthcare.gov, the portal for the online health insurance marketplaces, to shop for an Obamacare health plan for yourself or your family. Whether your state runs its own marketplace or has opted to let the federal government do it, you’ll be directed to individual plans in your area from that site.

Although anyone can buy a health insurance plan on the marketplaces, these exchanges are mainly aimed at people who don’t have other coverage options through work or health programs like Medicare or Tricare. If you have access to those types of coverage you generally can’t qualify for premium tax credits that make marketplace coverage more affordable.

All of the plans sold on the marketplaces have to cover 10 so-called essential health benefits, including hospitalization, prescription drugs, and doctor visits. But some plans’ coverage is more generous than others. Marketplace plans are split into four levels, named after metals. Bronze plans are the least generous; they pay 60% of the cost of covered services, on average. Silver plans pay 70%, gold plans 80%, and platinum plans pay 90%, on average.

Premium tax credits, which are available to people with incomes up to 400% of the federal poverty level (about $47,000 for one person or $97,000 for a family of four) are based on the second lowest cost silver plan sold in your area. If you buy a plan that’s pricier than the benchmark plan, you may have to pay a bigger share of the premium than if you bought one of the two cheapest silver plans or a bronze plan.

If you’re under age 30 you can buy a catastrophic plan. Premiums are generally lower than for bronze plans, but they have a high deductible of $6,850.

Generally, you have to sign up for Obamacare plans during the annual open enrollment period in late fall/winter. If you get married, lose your on-the job coverage, or have other major life changes you may qualify for a special enrollment period to sign up mid year.

If you make more than 400% of the federal poverty level you can’t qualify for premium tax credits, so there’s no advantage to buying a plan on the state marketplace. If you buy through a broker or from the health insurer directly, you may have more choices for plans or providers. No matter where you buy, however, all the plans sold on the individual market will be split into the same metal levels and cover the essential health benefits, among other things.

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