Health Plan Cost and Availability in California

“How much will Obamacare insurance cost me,” is a question many California residents have before enrolling in a plan. California Obamacare health insurance plans costs can be confusing when signing up for coverage. Determining ACA insurance price estimates in California prior to confirming a purchase is beneficial for those on a fixed budget and those who want to estimate annual health care expenses. Find out more about types of insurance plans available through ACA and how much they cost in our comprehensive California guide.

Obamacare Health Insurance Plans Costs in California

How much does Obamacare cost each participant? When determining how much Obamacare insurance will cost in California, you will need to consider the monthly premium, deductible, copayments or coinsurance as well as the out-of-pocket maximum. ACA insurance price estimates will depend upon your choice of coverage and amount of services you require. ACA plans offer four categories of health insurance:

  • Platinum level: The highest level plans cover 90 percent of your medical expenses, leaving the remaining 10 percent your responsibility. Although this plan has the highest premium, you will benefit from the lowest out-of-pocket costs.
  • Gold level: These plans pay 80 percent of your medical bills and leave you 20 percent to cover.
  • Silver level: Silver plans cover 70 percent of medical expenses and you pay the remaining 30 percent. This plan is the only version of Obamacare health insurance coverage in which you may qualify for cost-sharing reductions, which depend on your level of income.
  • Bronze level: The lowest level of plans pay 60 percent of medical expenses while you pay 40 percent. Although the bronze level plans have the lowest premiums, they have the largest out-of-pocket expenses.

Each of the four levels of Obamacare health insurance plans offer the same core of essential health benefits including inpatient, outpatient and emergency care. The ACA insurance price estimates have nothing to do with quality of care and whichever level health insurance plan you choose, you will still get the same service. The metal tiers determine the share of health care costs between you and the insurance provider. By means of an example, a platinum tier plan may cost $15 for a visit with your primary care physician, whereas a bronze plan may result in a $75 bill for the same service.

Learn more about the metal categories of ACA insurances, download our detailed California guide.

Estimating ACA Insurance Prices and Subsidies for California Residents

Whether you will get an Obamacare health insurance plan with subsidies will depend on your household income and the size of your family. If you do qualify for a reduction in your ACA insurance cost, then you may have lower monthly premiums with up-front tax credits. Your ACA health insurance plan may be reduced if your household earns less than a certain percentage of the federal poverty level (FPL). Depending on how much the household earns collectively in comparison to this amount will influence the amount of the subsidy. For instance, a family of four with a household income of $97,000 would be eligible for less tax credits than a family of four with annual earnings of $72,000. Likewise, a family of four with collective earnings less than $33,900 may not be eligible for any subsidies, but qualify for free health insurance through Medi-Cal. A low income may also have your annual out-of-pocket ACA insurance cost reduced. Individuals and families with low incomes will have an out-of-pocket medical expenses cap.

Health insurance premiums will vary depending on where you live. This will affect the cost of your ACA insurance price because the cost of living, which includes the cost of healthcare, is higher in some areas than it is in others. The government adjusts tax credits based on regional variations in insurance costs. For instance, someone living in San Francisco would have much higher medical cost than a Los Angeles resident would. The subsidies are balanced so the San Francisco enrollee would receive a higher tax credit and would ultimately pay a similar price as the individual in Los Angeles. Similarly, some Obamacare health insurance plans are only available in certain areas of the state.

How much Obamacare insurance costs is also influenced by age of the enrollee. As California residents age, their health care costs tend to be higher since they typically need more services than younger participants do. As a means of example, the subsidy for a resident who is 62 years of age will be three times the amount as the tax credit for someone of similar health who is only 27 years of age. Residents younger than a certain age can also signup for catastrophic insurance, which has a high deductible but very low monthly premium. When applying for Obamacare, applicants older than the age limit but with very low incomes may be eligible for catastrophic insurance.

As of 2017, the average Obamacare health insurance plans cost for monthly premiums in Northern California is $453, while it is $346 in Southern California. Find out more about health insurance costs and how to decide which metal tier plan works best for you and your family by reviewing the useful information in our California guide here.


What Are the Available Health Services in California?

Low-cost, and even free health benefits are available to a large number of California residents, with some being offered to low-income applicants and others being offered to elderly or disabled individuals. However, before you can access these health services, you need to submit the appropriate application and prove that you meet the necessary qualifications. To learn all about the different health benefits you can receive in California and the application procedures that you must undergo to obtain these benefits, download our free comprehensive guide.


Who Is Eligible to Obtain California Health Benefits?

California’s health programs have various eligibility requirements that applicants must meet in order to successfully enroll. Income, age and other factors are all taken into consideration in the eligibility verification process. Find out which health benefits you qualify for here.