Health Care Subsidy Calculator

Health Insurance Premium Calculator:

Average premium and subsidy amounts are based on a Silver plan. You have the option to apply the subsidy toward the purchase of other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive).

Out of Pocket Costs

Your out-of-pocket maximum for a Silver plan (not including the premium) can be no more than $10,400. Whether you reach this maximum level will depend on the amount of health care services you use. Currently, about one in four people use no health care services in any given year.

You are guaranteed access to a Silver plan with an actuarial value of 73%. This means that for all enrollees in a typical population, the plan will pay for 73% of expenses in total for covered benefits, with enrollees responsible for the rest. If you choose to enroll in a Bronze plan, the actuarial value will be 60%, meaning your out-of-pocket costs when you use services will likely be higher. Regardless of which level of coverage you choose, deductibles and copayments will vary from plan to plan, and out-of-pocket costs will depend on your health care expenses. Preventive services will be covered at no cost to you.

Other Coverage Options

Children and young adults under age 30 are eligible to purchase catastrophic coverage. With a catastrophic plan, you would pay out-of-pocket for most health services until you reach the annual limit on cost sharing ($12,700 in 2014). However, preventive services are covered at no cost to you.

Children under the age of 19 may also be eligible for coverage under Medicaid or the Children’s Health Insurance Program (CHIP), depending on your state’s eligibility requirements.