Nov. 11, 2013
It’s perhaps the
most common question people might ask: How much will health insurance purchased
on the Affordable Care Act’s (ACA’s) health insurance marketplace cost?
of the Texas Medical Association’s (TMA’s) “Hey, Doc” weekly education campaign
answers that question and more.
ninth week of “Hey, Doc” education programming
it cost me to buy this insurance?
costs depend on a lot of things like where you live, your age, how many people
are in your family, the services you need, and whether you smoke. And your
income determines whether the federal government will help you pay for your
What you pay also
depends on which category of insurance you choose in the marketplace: bronze,
silver, gold, or platinum. In bronze and silver plans, you might pay a lower
monthly charge, called a “premium,” but you might have to pay a higher cost
later when you use the insurance. The opposite happens when you buy gold and
platinum plans; they tend to have higher premiums and lower out-of-pocket
Here’s an idea of
what those costs might look like, on average:
- In a bronze plan, insurers pay for 60 percent of the
charge for medical services; patients, 40 percent.
- In a silver plan, insurers pay for 70 percent;
patients, 30 percent.
- In a gold plan, insurers pay for 80 percent;
patients, 20 percent.
- In a platinum plan, insurers pay for 90 percent;
patients, 10 percent.
You won’t know
your costs for sure until you fill out a marketplace application. But until then,
you can get a rough idea using this calculator tool created by the Kaiser
regardless of whether a plan is bronze, silver, gold, or platinum, don’t forget
to check out the other details besides costs, like the kind of insurance and
the doctor and hospital networks. Those things are important to keep in mind
when comparing your options and choosing a plan that works for you and your
TMA’s next “Hey, Doc” report:
Week of Nov. 18:
What are the subsidies? Who gets a subsidy? How do I apply for a subsidy?
TMA is the
largest state medical society in the nation, representing more than 47,000
physician and medical student members. It is located in Austin and has 112
component county medical societies around the state. TMA’s key objective since
1853 is to improve the health of all Texans.
Contact: Pam Udall
cell: (512) 413-6807
Contact: Brent Annear
phone: (512) 370-1381
cell: (512) 656-7320
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