Street sign that says "silver lining ahead"

Silver plans are the most common health insurance selections for Americans choosing between Affordable Care Act (ACA) plans. Discover why, and if this level of plan will meet your needs, with HealthMarkets.

What Is a Silver Level Health Plan?

A silver level health plan is one of four categories, or “metal levels,” of health insurance marketplace plans. Silver plans fall in the middle when it comes to costs: moderate premiums and moderate out-of-pocket expenses. If you qualify for cost-sharing reductions (or “extra savings”), you can save on out-of-pocket expenses — such as deductibles, copayments, and coinsurance — if you pick a marketplace silver plan.

What Does a Silver Plan Cover?

Silver plan insurance covers 10 essential health benefits, including, but not limited to prescription drugs, pediatric services, emergency services, hospitalization, and maternity care. In the silver metal level option, an insurance company covers 70% of health expenses, while you pay the other 30%.1

How Much Does the Silver Plan Cost?

The average lowest-cost silver plan premium is $436 as of 2021.2 The premiums available to you will vary depending on the insurance company, where you live, your household size, and other factors.

Why Are Silver Plans Different Now?

As you may know, the federal government decided to end cost-sharing reduction (CSR) payments in 2017.3 These payments went to insurance companies, allowing the companies to lower the cost of out-of-pocket expenses for low-income consumers. With the payments discontinued, insurance companies had to make a tough decision in order to ease their losses and stay in business: increase the premiums for silver plans.

An Unintended But Positive Result: Increased Subsidies

Although this was unfortunate for insurance companies, it ended up being good news for consumers. Why? Because the premium hikes that were applied to the health insurance silver plans had an unintended but positive effect on premium subsidies. Since premium subsidies are determined by both income and the second-lowest silver plan premium available in your area, the premium subsidy you receive (if you’re eligible) will increase as the premiums of ACA silver plans increase.

Additionally, premium subsidies can be used on any metal level plan. The amount of your subsidy will not change based on the metal level plan you choose. You could end up with a gold plan that costs less, and has better coverage, than a plan you could previously afford.

On top of that, the American Rescue Plan Act of 2021 temporarily expanded eligibility for premium subsidies. As a result you may qualify for even lower premiums or a zero-premium bronze OR silver plan.4

Not Eligible for a Subsidy?

For those who are not eligible for premium subsidies, there is another way to sidestep increasing silver health insurance premiums: shop outside the marketplace.

  1. Silver plan premium increases are associated only with CSR payments.
  2. CSR payments are only for plans available on the marketplace.
  3. Plans off the marketplace were not affected by the loss of these payments, so there is no need to hike premium rates.

This is ideal for individuals who want silver plans but don’t qualify for a subsidy.

Go for Silver, Bronze, Gold, or Platinum This Year

If you are one of the 29 million people eligible for lower premiums or premium subsidies, it may be worth your while to purchase a gold plan this year.5 Platinum plans may be within reach but be sure that your subsidy covers the extra costs before applying. And finally, those within certain income levels should consider finding $0 premium bronze or silver plans.

Either way, HealthMarkets can help. A licensed insurance agent can help you find coverage that matchers your needs at a cost that meets your budget. Call an agent today at (800) 304-3414.

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References

1. “Silver Health Plan.” HealthCare.gov. Retrieved from https://www.healthcare.gov/glossary/silver-health-plan/ Accessed May 7, 2021. | 2. “Average Marketplace Premiums by Metal Tier, 2018-2021.” KFF. 2021. Retrieved from https://www.kff.org/health-reform/state-indicator/average-marketplace-premiums-by-metal-tier/ | 3. “Analysis: ‘Silver loading’ led to exodus to bronze-tier plans in majority of states.” FierceHealthcare. October 202. Retrieved from https://www.fiercehealthcare.com/payer/analysis-silver-loading-led-to-exodus-to-bronze-tier-plans-majority-states | 4. “Obamacare’s About to Get a Lot More Affordable. These Maps Show How.” NYT. March 2021. Retrieved from https://www.nytimes.com/2021/03/10/upshot/stimulus-obamacare-lower-costs.html | 5. “Two New Analyses: House COVID-19 Relief Plan Would Temporarily Lower Marketplace Premiums for Millions and More than Offset Short-Term State Costs to Expand Their Medicaid Programs.” KFF. February 2021. Retrieved from https://www.kff.org/health-reform/press-release/two-new-analyses-house-covid-19-relief-plan-would-temporarily-lower-marketplace-premiums-for-millions-and-more-than-offset-short-term-state-costs-to-expand-their-medicaid-programs/

Disclaimer: Those with incomes between 100% and 150% of the federal poverty level (FPL) may qualify for a zero-dollar premium silver plan (after tax credits). They may also qualify for a zero-dollar premium bronze plan (after tax credits). Cost sharing (deductibles and coinsurance) may vary.

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