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FCTA calculates Obamacare costs in Virginia

FCTA calculates Obamacare costs in Virginia

-- by Thomas Cranmer, FCTA, 09/24/2014

Presented are the latest calculations of Obamacare costs, using the Kaiser Family Foundation's Subsidy Calculator. Anyone can go to the free anonymous calculator without entering their name, social security number or address. It takes only five minutes. The results for a Silver Plan are:

Summary Results:
For a Northern Virginia family of four earning a gross income of $50,000 per year:


    - Deductible out of pocket:  $10,400
    - Premium:                    $8,348
    - Total:                     $18,748 (or 38% of $50,000 income)

For a Northern Virginia family of four earning a gross income of $100,000 per year:


    - Deductible out of pocket:  $12,700
    - Premium:                   $13,920
    - Total:                     $26,620 (or 27% of $100,000 income)

Side note: The Subsidy Calculator used to be on the Obamacare web site and easy to click on. HHS removed it, because they did not want people to see the horrible costs.

Detailed Calculator results for family of 4 with $50,000 income:

Enter Information About Your Household:

   1. Select a State:                     Virginia
      Enter your zip code:                22066
      Select county:                      Fairfax

   2. Enter income as:                    2014 Dollars

   3. Enter annual income (dollars):      50000

   4. Is employer coverage available?     No

   5. Number of people in family:         4

   6. Number of adults (21 and older)     2 Adults
      enrolling in exchange coverage:
        Age? 21  Uses Tobacco? No
        Age? 21  Uses Tobacco? No

   7. Number of children (20 and younger) 2 Children
      enrolling in exchange coverage:
        How many Children use Tobacco? 0

RESULTS:
The information below is about subsidized exchange coverage. Note that subsidies are only available for people purchasing coverage on their own in the exchange (not through an employer). Depending on your state's eligibility criteria, you or some members of your family may qualify for Medicaid.

   Household income in 2014:        212% of poverty level

   Maximum % of income you          6.73%
   have to pay for the premium,
   if eligible for a subsidy:

   Health Insurance premium         $8,349 per year
   in 2014 (for a silver plan,
   before tax credit):

   You could receive a              $4,983 per year
   government tax credit            (which covers 60% of the overall premium)
   subsidy of up to:                [Not permitted in Virginia!]

   Amount you pay for the           $3,365 per year
   premium:                         (which equals 6.73% of your household
                                    income and covers 40% of the overall
                                    premium)

OTHER LEVELS OF COVERAGE:
The premium and subsidy amounts above 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).

For example, you could enroll in a Bronze plan for about $415 per year (which is 0.83% of your household income, after taking into account $4,983 in subsidies). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.

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 with no cost sharing required.

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 with no cost sharing required.

Detailed Calculator results for family of 4 with $100,000 income:

Enter Information About Your Household:

   1. Select a State:                     Virginia
      Enter your zip code:                22066
      Select county:                      Fairfax

   2. Enter income as:                    2014 Dollars

   3. Enter annual income (dollars):      100000

   4. Is employer coverage available?     No

   5. Number of people in family:         4

   6. Number of adults (21 and older)     2 Adults
      enrolling in exchange coverage:
        Age? 21  Uses Tobacco? No
        Age? 21  Uses Tobacco? No

   7. Number of children (20 and younger) 2 Children
      enrolling in exchange coverage:
        How many Children use Tobacco? 0

RESULTS:
Because your income is more than 400% of the poverty level, you would not qualify for subsidized exchange coverage. The information below is about unsubsidized exchange coverage.

   Household income in 2014:        425% of poverty level

   Maximum % of income you          None
   have to pay for the premium,
   if eligible for a subsidy:

   Health Insurance premium         $8,349 per year
   in 2014 (for a silver plan,
   before tax credit):

   You could receive a              $0 per year
   government tax credit            (which covers 0% of the overall premium)
   subsidy of up to:

   Amount you pay for the           $8,349 per year
   premium:                         (which equals 8.35% of your household
                                    income and covers 100% of the overall
                                    premium)

OTHER LEVELS OF COVERAGE:
The premium and subsidy amounts above 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).

For example, you could enroll in a Bronze plan for about $5,399 per year (which is 5.4% of your household income). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.

OUT OF POCKET COSTS:
Your out-of-pocket maximum for a Silver plan (not including the premium) can be no more than $12,700. 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.

A Silver plan has an actuarial value of 70%. This means that for all enrollees in a typical population, the plan will pay for 70% 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 with no cost sharing required.

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 with no cost sharing required.