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Cost: How much do I have to pay for my insurance coverage?

Aug 20, 2013

Marketplace health plans will be available in four easy-to-compare metal tiers (platinum, gold, silver and bronze). The amount a person pays out of pocket when they receive services will vary by metal tier. Plans in all metal tiers cover the required Essential Health Benefits, such as hospital stays, doctor’s visits, behavioral health, emergency care and prescription drugs. Some health plans will offer additional benefits, such as adult vision and dental coverage.

Premium rates will be further reduced for individuals and families with incomes below 400 percent of the federal poverty level ($45,960 for individuals and $94,200 for a family of four) because of financial assistance in the form of federal tax credits only available through the Marketplace. Federal tax credits limit the amount a person pays for insurance each month.  Monthly payments will be far below the cost of buying insurance today. For example, if a silver level plan is selected:

  • An individual with annual income of $17,000 will pay $55 per month.
  • An individual with annual income of $28,000 will pay $183 per month.
  • An individual with annual income of $40,000 will pay $252 per month.
  • A family of 4 with annual income of $35,000 will pay $114 per month.
  • A family of 4 with annual income of $59,000 will pay $457 per month.
  • A family of 4 with annual income of $82,000 will pay $739 per month.
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