Will I qualify for lower out-of-pocket costs when I use my plan under ACA?

December 21, 2013

When you purchase health insurance coverage through AHIPE or the public exchange (government website), you might be able to get lower costs on deductibles, copayments and other out-of-pocket expenses. It depends on your income and family size.

 

Qualifying for lower out-of-pocket costs in the exchange:

 

When you purchase a qualified plan through the exchange, the amount you pay in out-of-pocket expenses for Essential Health Benefits is based on your income. It's on a sliding scale to keep it affordable for you.

 

Estimating Your Income:

 

Use this 2013 information as a reference, even though the amounts are likely to be slightly higher in 2014. Also, amounts can be different based on family size, up to 8 family members.

 

* Up to $28,725 for individuals

* Up to $38,775 for a family of 2

* Up to $48,825 for a family of 3

* Up to $58,875 for a family of 4

* Up to $68,925 for a family of 5

* Up to $78,975 for a family of 6

 

This is not to be confused with subsidized premiums:

 

You can qualify for reduced monthly premiums without qualifying for reduced out-of-pocket expenses when you use your plan. 

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