Choosing a Plan

Which Plan is Best for Me?

Choosing a Plan In general, if you expect to have a lot of health care visits or require regular prescriptions, you may be better off with a Gold or Platinum plan that pays a higher percentage of the costs. If, on the other hand, you are by-and-large healthy and don’t expect to have many health care bills, you might be comfortable choosing a Bronze or Silver plan. Of course, even healthy people can have accidents or become ill and end up with lots of medical bills, so you have to factor in your risk tolerance as well.

If your income falls between 100 and 250% of the federal poverty level ($11,490 to $28,725 for an individual), you may be eligible for a Cost-Sharing Reduction subsidy, which can help lower your deductibles, copayments and coinsurance. In order to receive Cost-Sharing Reductions, you must purchase a Silver plan on the Marketplace.

Many people will qualify for Advanced Premium Tax Credits, a type of subsidy that lowers your monthly premium. You may be eligible for this subsidy if your income falls between 100 and 400% of the federal poverty level ($11,490 to $45,960 for an individual).


TIP The Cost-Sharing Reduction and Advanced Premium Tax Credits subsidies are not automatic: you must apply for them on the Health Insurance Marketplace.

The Bottom Line

When choosing a plan, it is helpful to remember that all plans – Bronze, Silver, Gold and Platinum – cover the same Essential Health Benefits. Your monthly health insurance premium will be higher if you choose a higher level plan, such as Gold or Platinum. But you will also pay less each time you visit a health care provider or get a prescription filled. Conversely, your monthly premium will be lower if you choose a Bronze or Silver plan, but you will pay more for each doctor visit, prescription or health care service that you use.



Helpful Links:

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