Health Plan Cost and Availability in Ohio
Before you can explore ACA insurance price estimates in Ohio, it is important to understand a little bit about how ACA health care plans are organized, what Obamacare plans cover and what decisions you will need to make when selecting the best plan for your needs. The difference in Ohio Obamacare health insurance plans costs comes not from the types of benefits they offer enrollees, but other key factors. When it comes to answering, “How much will Obamacare insurance cost me?” it depends on how health care costs are divided between the insurance plan and the policyholder, the limitations on access to out-of-network care and the premium tax credits and other subsidies for which an enrollee qualifies. In light of these variables, the common question, “How much does Obamacare cost in Ohio?” can only be accurately answered once an applicant has determined his or her needs and priorities (or those of the family unit), including the appropriate level of deductibles, copayments and out-of-pocket costs. To learn more about Obamacare insurance price estimates, continue on to the sections below.
Cost Terminology Associated With ACA Health Plans
Before examining how much Obamacare costs, it is important to become familiar with the terminology associated with health care coverage in Ohio. To start, a deductible is the amount of money an eligible ACA insurance plan-holder has to pay for health care services before insurance kicks in and begins to pay some of the costs. When it comes to ACA insurance prices, deductibles do not apply to mandated primary or preventative care. When you have reached your deductible limit and your insurance plan has begun to pay for some or most of the expenses you incur, you may still be responsible for a portion of the ACA cost estimate for each product or service; this is commonly referred to as your copay. Your plan may also include an out-of-pocket maximum limit. Once you have expended your out-of-pocket maximum on health care costs (through your deductible and subsequent copays), your insurance plan will pay the full cost of all remaining eligible products and services. Learn more about Obamacare costs by downloading our free and informative guide.
Types of Obamacare Health Plans
There are four levels of Obamacare health insurance plans available through the Marketplace: Bronze, Silver, Gold and Platinum. When asking, “How much does Obamacare cost, and what coverage should I choose?” it is important to examine all health care plan tiers and what they offer.
Bronze plans offer the most basic level of coverage. Under these plans, you pay 40 percent of your ACA health care costs, and the insurance company pays 60 percent. Monthly premiums are low, but out-of-pocket Obamacare costs under this plan can be very high. Bronze plans are recommended for patients who require minimal care, and simply desire coverage in the event of a serious accident or illness.
Silver plans provide a higher level of coverage, where policyholders pay 30 percent of their Obamacare health care cost estimates, while the insurance company is responsible for 70 percent. The ACA prices of premiums and deductibles are generally lower than those of Bronze plans, and more regular day-to-day care costs are covered.
Gold plans only require plan-holders to pay 20 percent of their expenses when it comes to how much Obamacare insurance will cost; the plan covers 80 percent. Monthly premiums of these ACA plan costs are noticeably higher than under Bronze or Silver plans, but deductibles and out-of-pocket costs are significantly lower. These plans are recommended for those looking to learn how to apply for ACA coverage that require higher levels of care.
Platinum plans begin paying for plan-holders’ ACA healthcare cost estimates sooner than other plans, and cover 90 percent of costs; plan-holders will pay only 10 percent. These plans are considered best for patients who utilize high levels of care, and can afford to pay the high premiums in exchange for much lower costs at the time of service.
A small portion of the population will qualify to purchase Catastrophic plans. These Obamacare health insurance plans are only available to applicants younger than the age of 30, or those who qualify for certain exemptions. The costs of ACA policies that are catastrophic plans carry extremely low premiums and equally high deductibles. Like all other ACA plans, they cover services, and offer full coverage of predetermined preventative health care services. Download our complimentary guide to review more information about Obamacare health plans and costs.
To determine any reliable ACA insurance price estimates, once you have selected a plan level, you will need to further refine your selection. Some ACA plans, such as Exclusive Provider Organization (EPO) plans, only cover the costs of care delivered by approved, in-network providers. Health Maintenance Organization (HMO) plans typically cover the ACA cost estimates of out-of-network services only in the event of an emergency. Point of Service (POS) plans manage access to out-of-network providers through referrals and include higher Obamacare prices. Preferred Provider Organization (PPO) plans offer slightly more access to out-of-network providers, but incentivize plan-holders to stay within network by offering lower costs. Each applicant must assess his or her own needs, priorities, preferences and ACA cost budget to determine which of these options best fits his or her circumstances.
ACA Insurance Price Estimates in Ohio
How much Obamacare costs a given applicant is determined not only by the level and type of plan(s) selected, but by the subsidies and cost savings for which an applicant is qualified. An applicant’s annual income and family size are used to determine if the individual or family is eligible for a premium tax credit. If an applicant is eligible for premium tax credits to help with the cost of Obamacare coverage in Ohio, the subsidy is sent directly from the government to the insurance provider each month, reducing the amount the plan-holder must pay. It is vital to note that changes in income or family size can directly and immediately impact benefit premium tax credit levels. These changes will be weighed and balanced annually when the enrollee files his or her taxes.
Some Obamacare health insurance plan applicants will also be income-eligible for Cost-Sharing Reductions (CSR). CSRs can only be used with Silver plans, but can result in significant Obamacare coverage cost savings for plan-holders through reduced deductibles, copays and out-of-pocket maximums. Unique income eligibility rules for CSRs are available to American Indians and Alaska Natives. Learn more about Ohio Obamacare costs in our comprehensive guide.