2017 Silver 87: Enhanced Plan

The Silver 87 Plan is a health plan that gives qualified members more coverage at lower prices. Someone on a Silver 87 Plan will pay less for medical services than someone who is enrolled on a top-of-the-line Platinum Plan. It gives individuals and families a chance to have affordable health insurance without sacrificing good benefits. To see if you qualify, click Affordable Health Insurance for California to receive a free quote.

Typical services such as doctor visits, generic  prescriptions, labs, and x-rays are available immediately at a flat rate, commonly called a copay. High-cost services, such as hospitalization, etc. are subject to a $650 deductible per individual or $1,300 for a family. The annual drug deductible is $50 per individual or $100 for a family. The plan has a calendar year maximum of $2,350 for an individual or $4,700 for a family, so the member never pays more than this amount in a year. 

Is the Silver 87 Right For Me?

  • More often than not, if you qualify for the Silver 87, it will provide you the best coverage for the price.
  • Since the service fees and deductible are low, people with serious or chronic health conditions may wish to consider enrolling on a Silver 87 Plan, if they are eligible.

To qualify for an Enhanced Silver 87 Plan, the application must be submitted through Covered California and the individual must meet Covered California income limits. To understand better, review the Federal Poverty Level ChartChildren 18 and under are not eligible for an enhanced Silver 87 Plan and may qualify for Medi-Cal or can enroll on a plan at the full price.

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Price: $$ and less

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Deductible: $650/$1,300 (ind/family)

Doctor Visits: $10

Generic Drugs: $5

Hospital: 15% after deductible

OOP Max: $2,350/$4,700 (ind/family)

A Little More to Think About

Your income is a big factor in qualifying for the Silver 87 Plan. If you qualify, take advantage of the great benefits, but realize if your income increases you may have to select a new plan with different benefits that don’t compare. So if you are putting off a surgery or procedure that you need, do it now while you qualify.

Note that the coverage benefits may be different when a doctor or provider is not part of the insurance carrier’s network.  For details, consumers are encouraged to check with the carrier or insurance agent for details.