Acting Insurance Commissioner Jessica Altman today urged Altoona area consumers who need individual health plans to shop around and examine different plans because gold or bronze level Affordable Care Act (ACA) plans may be a better deal.
Below are examples of how different consumers in the Altoona area could save money by choosing a gold or bronze rather than silver plan on Healthcare.gov, or buying a plan directly from an insurer outside of Healthcare.gov. Altman cautioned consumers to make sure any plan they buy outside of Healthcare.gov complies with the requirements of the Affordable Care Act, by asking their insurance professional or talking directly with the five insurers selling plans on the individual market in Pennsylvania. These insurers are Capital BlueCross, Geisinger, Highmark, Independence Blue Cross, and UPMC Health Plan.
• In Altoona, a family of four with a tax credit of $230 may find a silver plan with a premium (after subsidies) of $482. A similar gold plan would cost $456 per month after the subsidy is taken off. By shopping around, the family would likely find the best deal for themselves in a gold plan, with lower premiums, as well as a deductible that is $5,400 less than the silver plan.
• Without subsidies, the same family in Altoona could pay $864 for a similar off-exchange silver plan or $1,162 per month in premiums for an on-exchange silver plan. By shopping around, the family would save nearly $300 per month in premium payments.
• An Altoona family of four making $47,100 a year could get a bronze plan with a $0 monthly premium, with a $13,900 deductible.
• A 30-year-old single individual in Altoona receiving tax credit subsidies can get a gold plan for $12 a month less than a silver plan, with the deductible being $800 for the gold plan, and $3,500 for the silver.
• A single person not receiving tax credit subsidies can get an off-exchange silver plan for $82 a month less than an on-exchange plan. A gold plan on- or off-exchange would be $62 a month more in premiums than an off-exchange silver plan, but would have a deductible of $800 versus $1,800 for the silver plan.
• A single person in Altoona earning $22,000 annually could get a $0 monthly premium bronze plan, with a $6,950 deductible.
“We are hearing concerns from consumers who are seeing large premium increases, due to the Trump Administration ending cost-sharing reduction payments. Insurance companies did not include cost sharing in their premiums in the past due to the federal government making the payments,” Altman said. “However, tax credit subsidies, which help about 80 percent of Pennsylvanians pay for their plans bought on Healthcare.gov, increase when the premiums on the silver level plans increase.”
This tax credit subsidy increase goes with the individual. Gold level plan premiums have risen much less than silver plans in most cases, because ending the cost-sharing reduction payments caused only silver plan premiums to rise disproportionately, so while an individual with a generous tax credit subsidy and cost-sharing reductions may want to stick with their silver plan, many individuals with less generous tax credits may want to consider gold or bronze plans. Some consumers may now be able to buy the more generous gold plans for a lower premium than the silver plans. Gold plans have lower out-of-pocket costs, such as deductibles and co-pays, thus costing consumers less overall if premiums are lower than silver plans.
“Some consumers who qualify for subsidies may also be able to find very low dollar or even zero dollar monthly premium bronze level plans,” Altman said. “These plans may be a viable option for consumers who don’t expect to have significant medical costs in the coming year. However, bronze plans have much higher deductibles, so consumers who purchase these could end up paying much more out-of-pocket if they have higher than anticipated medical costs.”
“For consumers who either don’t qualify for tax credit subsidies at all, or for very small subsidies due to their income, off exchange silver plans, bought directly from health insurers outside of Healthcare.gov, are available and were not impacted by the loss of cost-sharing reduction payments,” Altman added. Tax credit subsidies are available only for plans bought on Healthcare.gov, so consumers who think they might be eligible for financial subsidies should shop on Healthcare.gov. Altman also encouraged all consumers to visit Consumers’ Checkbook at https://pa.checkbookhealth.org to see what plans are available where they live. Individuals with annual incomes up to approximately $48,000 are eligible for tax credit subsidies. A family of four is eligible with an income up to approximately $98,000.
Altman also said some consumers who have health plans from 2017 may have received a letter from their insurance company with the 2017 tax credit information, and not the increased 2018 tax credit. This is another reason Altman urges consumers to visit the Consumers’ Checkbook site and compare available plans in their area.
“We really encourage people to use Consumers’ Checkbook because the tool allows consumers to sort by premium or by total yearly cost, and it provides an estimate of out-of-pocket costs for a good year and a bad year. This estimate includes premiums, deductibles, copays and other cost-sharing,” said Altman.
Visit www.insurance.pa.gov., for more information on 2018 rates and additional resources for shopping for health insurance.