Obamacare News Blog

Bronze Plan: Substantially Higher Cost When You Use Health Care

Covered California warns users on their website that if you choose the Bronze Plan for its low monthly premium you will pay a “substantially higher cost when you use health care.” Bronze is projected to be the most popular plan for the healthy, however it doesn’t cover more than 3 doctor’s visits before meeting the $5,000 deductible.

How to Choose a New “Metal” Plan

The new metal plans are known as the ObamaCare Bronze, Silver, Gold, and Platinum Health Plans. But which do you choose. This depends on whether you qualify for Affordable Care Act subsidies, your current state of health, and what you can afford, both monthly and year round for care.

Why Does Covered CA offer a Bronze Plan Warning

Bronze plans have the lowest individual and family monthly premium, but that doesn’t mean that plan will cost you the least throughout the year. Covered CA wants its enrollees to understand that even though Bronze, Silver, and Gold all have the same out-of-pocket max, seeking even minimal care with the Bronze plan could be the most costly.

For the first 3 doctor’s visits the copay is $60 each, and for any other care you pay the negotiated rate until you have satisfied the rather high deductible. Whereas with Silver and Gold you will pay $45 and $30 copays, respectively, for each doctor’s visit regardless of whether you satisfy a deductible (Gold doesn’t have a deductible). Silver also offers copays before meeting your deductible for such things as generic drugs, Xrays, and lab work.

Difference Between Bronze and Silver Costs

In Los Angeles the lowest Bronze Plan for a 40 year old costs $196 a month, while the lowest Silver Plan for that same person costs $244 a month, for a difference of $576 a year. Seems like a great savings, but if you take into account Bronze’s higher copays, no drug coverage or other coverage besides 3 doctor’s visits before the deductible is met, it could cost you a lot more. Say you go to five doctor’s office visits in the year (2 extra visits at $125 each) and need three prescriptions of Generic drugs each at $40, and lab work done at $150. Silver would save you $373 for these common health needs.

Other Plans Available Than New ACA Exchange Plans

A little known fact is that you can purchase plans outside of the Exchange. Why would you do this? Well, if you know you don’t qualify for subsidies why would you fill out extra paperwork (estimated at 10 minutes of time just to know if you qualify), plus for others there is a more significant reason: many people prefer to keep their finances private by not having to answer questions about alimony, child support, assets, and investments. These off-Exchange plans may either be identical to the “metal” plans or in some cases the insurance provider may offer more bang for your buck.

For further questions about which plan is right for you call 800-930-7956 or contact Medicoverage.