Here’s the skinny on ObamaCare premiums …

The recent Forbe’s article that we reported on yesterday said that the ObamaCare web site gets bogged down because folks need to enter their private info in order to get a premium quote.


Forbes (and other pundits) say that the “list price” of the premiums are much higher than people expect … so the Feds want to calculate the ObamaCare subsideis first and quote people a net price … after taking the subsidies into account.

That got me curious.

How much are ObamaCare premiums … and what are the policy terms & conditions re: deductibles, co-pays, etc.?

So, I did some hunting … and, in fact, it takes some hunting.

Best source that I found is a tool developed by the Kaiser Family Foundation (link below).


The Kaiser calculator requires just a couple of inputs … no private information.

Here’s what I input: Family of 4, non-smokers, $100K household income.


OK, place your bets.

What do think the annual premium would be?

Answer: Just under $9,000 per year for the mid-range “Silver” plan ,,, list price = net price since the %100k is above the subsidy thresholds.




$9,00 per year sounded pretty good to me … I was expecting a number more like $12,500.

Here’s the rub:

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.

The other 30% ….

Think co-pays and deductibles … which vary from plan to plan.

There is a cap on out-of-pocket spending.

For a Silver plan (not including the premium) the cap is is $12,700.

That is, once a person’s co-pays and deductibles hit $12,700 … they don’t have to shell out any more.

I wonder if folks know that they may still be on the hook for more than $12,000?

The Feds point out: “Whether you reach this maximum level will depend on the amount of health care services you use.”

No kidding?


Put it all together: $9,000 for a policy that covers about 70% of healthcare expenses with a $12,700 spending cap

I’ll let you decided whether that’s a good deal or not.

If you want to play with the Kaiser calculator, go to the Kaiser site.

* * * * *
Follow on Twitter @KenHoma               >> Latest Posts


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s