How Much Does Obamacare Cost in New York?
This article explains the costs of health care plans offered under Obamacare (the Affordable Care Act of 2014) for individuals or families who are currently uninsured or not covered by a job-based health plan.
What you'll pay for an Obamacare plan depends on five things:
- The level of coverage you choose
- Whether you qualify for a subsidy
- Where you live in New York
- Your age
- Whether you smoke
Read on to learn more about each of these factors.
1. The Level of Coverage You Choose
Obamacare insurance plans offer four levels of coverage:
Platinum -- covers approximately 90% of health care costs
Gold -- covers approximately 80% of health care costs
Silver -- covers approximately 70% of health care costs
Bronze –- covers approximately 60% of health care costs
Bronze plans carry the lowest monthly premiums, but you will pay the highest out-of-pocket costs for health care services. Platinum premiums are highest, but additional expenses will be lower than with other plans.
All four categories offer the same essential benefits, including hospitalizations, prescription drugs, maternity care, and more. The categories don’t affect the amount or quality of care you will receive.
In addition to the categories above, if you are under the age of 30, you can purchase a “catastrophic” insurance plan at a lower cost than a bronze plan. These plans don’t qualify for the premium discounts discussed below. Under a catastrophic plan, you will probably have to pay all of your medical costs up to a certain amount, perhaps several thousand dollars. After that, the costs of essential health care benefits are paid by insurance.
2. Whether You Qualify for a Subsidy
Depending on your income and the size of your family, you may be able to reduce the costs of Obamacare insurance in one of the following ways:
Lower monthly premiums. You can lower the cost of your monthly premiums if you qualify for a tax credit. The credits are applied directly to your monthly premiums, so you save money right away.
Reduce out-of-pocket costs. If you meet the eligibility requirements, the total amount of your annual out-of-pocket costs will be reduced.
Obtain coverage under Medicaid or the Children’s Health Insurance Program (CHIP). Low-income individuals and families may qualify for free or low-cost health care coverage through one of these programs, instead of Obamacare. Many states will be expanding Medicaid eligibility in 2014, so your chances of qualifying may increase.
For details about these subsidies and to learn more about whether you qualify, see How to Save Money on Obamacare Plans.
3. Where You Live in New York
In most states, premiums vary depending on where you live. To learn more about costs in your region of New York, see the links at the end of this article.
4. Your Age
Under Obamacare, health plans must allow you to enroll regardless of your age, but the costs of your plan will most likely depend, in part, on how old you are. For specifics in New York, use the links at the end of this article.
5. Whether You Smoke
The Affordable Care Act allows insurance companies to charge people who use tobacco up to 50% more in monthly premiums than those who do not. (The average additional cost is about 20%.) In addition, subsidies can’t be used to cover any portion of the tobacco surcharge added to the monthly premium.
In New York, however, state law prevents insurance companies from charging higher premiums for tobacco users. As a New York resident, this factor will not affect your premium rates under Obamacare.
You can learn the final costs for specific plans, including whether you qualify for subsidies or low-cost care programs, by applying for insurance online at NY State of Health.
Useful Resource: Kaiser Family Foundation Subsidy Calculator
The Kaiser Family Foundation Subsidy Calculator is a quick way to get a rough idea of what kinds of costs and subsidies you're likely to face. It is embedded here for your convenience.