Obama Care Plans and Prices
Find 2017 Bronze, Silver, Gold and Platinum Obama Care Plans and Prices
It can be hard to decide which Obama Care plans and prices are right for you in 2017. But a quick look with at-a-glance information can make it very easy to narrow down which Covered California medical insurance coverage is right for you.
All medical insurance coverage that meets the requirements of the Affordable Care Act (ACA) are categorized by metal types to help people view Obama Care plans and prices with an apples to apples comparison. The number below the metal type is the approximate percentage the health insurance company will pay of your medical costs (60%, 70%, 80%, or 90%).
For more detailed information on Obama Care California plans, click on any plan below that interests you.
2017 Plan cost and coverage is from lowest to highest: Minimum Coverage , Bronze , Silver , Gold and Platinum . If you are eligible, and want financial assistance paying your health insurance premium through Covered California make sure you look at the Bronze, Silver, Gold or Platinum plans. The minimum coverage Obama Care plan is not eligible for a subsidy and has certain requirements of who can enroll on it.
Take note that the Silver tier offers an enhanced level of coverage for those whose annual income is within a certain percentage of the federal poverty level. To understand this better, check out the FPL chart . If you qualify for a Silver 73, Silver 87 or a Silver 94, typically this plan is going to be the “best bang for your buck.”
Best For: healthy individual/family whose main concern is affordability and coverage for catastrophic events. It is available only to those under 30 years of age or those who meet the hardship exemption. This Obama Care plan is not eligible for premium assistance.
Deductible: $7,150/$14,300 (individual/family)
Doctor Visit: no cost for first 3 visits*
Generic Drugs: you pay full price until your out-of-pocket maximum is reached
Hospitalization/Surgery: you pay full price until your out-of-pocket maximum is reached
Out-of-Pocket Maximum: $7,150/$14,300 (individual/family)
Features: free preventative care, 3 free office visits before the deductible is reached
Options: Minimum Coverage Plan
Bottom Line: Apart from 3 free doctor visits, you pay the full price for any needed medical services until the deducible is met. The most you would pay if the worst happened in a year is $7,150 per individual or $14,300 per family.
*First 3 visits each year are free and not subject to the deductible.
Best For: healthy individual/family that does not have health concerns but wants insurance just in case something major happens
Deductible: $6,300/$12,600 (ind/family)
Doctor Visit: $75
Generic Drugs: full price up to $500 per script after Rx deductible
Hospitalization/Surgery: full price up to Out-of-Pocket Maximum
Out-of-Pocket Maximum: $6,800/$13,600 (ind/family)
Features: free preventative care (The bronze Obama Care plan option offers first 3 office visits for $75-$105 copayment before the deductible is reached.)
Types: Bronze 60
Bottom Line: Outside of the 3 annual office visit for a copay of $75-$105, and lab work for $40, you pay the full price for any needed medical service until the deducible is met. The most you would pay out-of-pocket if the worst happened in a year is $6,800 per individual or $13,600 per family. Sure beats paying 100k for a hospital stay!
Click Bronze 60 HSA Plan for information on a health plan that offers an HSA (Health Savings Account) option.
Best For: individual/family who wants an affordable middle-of-the-road Obama Care plan that offers reasonable copays for common services such as occasional office visits, prescriptions drugs, etc.
**Deductible: $2,500/$5,000 (individual/family)
Doctor Visit: $35 – $70
Generic Drugs: $15
Hospitalization/Surgery: 20% after deductible
Out-of-Pocket Maximum: $6,800/$13,600 (individual/family)
Features: free preventative care, reasonable copays of $70 and under for office visits, lab work and generic drugs before the deductible is reached
Bottom Line: You pay copays for common services before the deductible is met. A deductible would apply for other services. The most you would pay if the worst happened in a year is $6,800 per individual or $13,600 per family. For the Silver 73, it would be $5,700 per individual or $11,400 for a family. For the Silver 87 and 94, it would be $2,350 for an individual and $4,700 for a family.
*Plan availability is based on eligibility and annual income. Please see FPL chart.
**Plan description of deductible, doctor visit, generic drugs, etc. are for the Silver 70 plan.
Best For: an individual/family that frequently uses medical services and/or wants an Obama Care plan without a deductible
Doctor Visit: $30 – $55
Generic Drugs: $15
Hospitalization/Surgery: $600 (per day up to 5 days if hospitalized) for most HMO’s, 20% for PPO’s and some HMO’s
Out-of-Pocket Maximum: $6,750/$13,500 (individual/family)
Features: free preventative care, no deductible, copayments for all covered services
Types: Gold 80
Bottom Line: You pay copayments for covered services. The most you would pay if the worst happened in a year is $6,750 for an individual or $13,500 per family.
Best For: an individual/family who wants the best Obama Care plan coverage available with low copayments, no deductible and the lowest out of pocket expense if the worst should happen in a year
Doctor Visit: $15 – $40
Generic Drugs: $5
Hospitalization/Surgery: $250 (per day up to 5 days if hospitalized) for HMO, 10% for PPO
Out-of-Pocket Maximum: $4,000/$8,000 (individual/family)
Features: free preventative care, low copayments, no deductible and lowest out of pocket maximum
Options: Platinum 90
Bottom Line: You pay copayments for covered services. The most you would pay if the worst happened in a year would be $4,000 per individual or $8,000 per family.