The Affordable Care Act federal insurance marketplace enrollment period begins Saturday, and a window shopping component of healthcare.gov went online late Sunday.
In a major step forward from last year, it works well. Type in your home address, age and annual income and you get a list of dozens of plans available through the marketplace at bronze, silver, gold and platinum levels based on their costs and benefits.
The website gives a rough estimate of the tax subsidy available based on age and income. The plan premium prices listed on the website deduct the subsidy, so they reflect actual premium costs to the individual.
For instance, a 36-year-old with $25,000 income in Lexington County would qualify for a $123.86 per month tax subsidy to reduce premiums on a federal insurance marketplace plan. For that individual, the least expensive silver level plan would have a $131 monthly premium (after subsidy), a $2,250 deductible and $5,000 maximum out-of-pocked expenses. One silver plan with a $159 premium has no deductible and a $5,200 maximum out of pocket.
Tax subsidies go down as income goes up, topping out at $46,680 income for an individual. Plans for a 55-year-old with $50,000 income would be much more expensive than a younger person with lower income. The cheapest bronze level plan for a 55-year-old with a $50,000 income would be $351 per month, with the cheapest silver plan $462 per month and gold plan $545 per month.
There are 126 plans available in South Carolina this year, though all aren’t available for all locations.
The window shopping also makes it relatively easy to check each plans’ provider network. Click on the plan’s “provider directory,” and it takes you to a search engine for the company’s list of doctors and facilities. It’s easy to check for your doctors, a little more difficult to find out if a nearby hospital is in the network.
If the window shopping confuses you more than it helps you, there are options beginning Saturday. Go to signupsc.org to find out about local enrollment events or to get an appointment with a trained navigator. Also, many private insurance agents are trained to help people through the system.