BlueCross BlueShield is (again) the only insurance company offering health insurance plans on the Obamacare Marketplace in South Carolina for 2018.
But there are a lot of plans to choose from. Which one is best?
Everyone’s situation is different, so there’s not going to be one plan that’s best for everyone. But here is a quick profile of a couple of plans that we expect to be the most popular (from least to most expensive):
BCBS Bronze 4
Historically, the only reason people buy bronze plans is because they are the cheapest. This is the first year we can recall there being a bronze plan that’s actually usable for most people.
Details:
- $6,200 / $12,400 deductible (individual/family); $7,150 / $14,300 out-of-pocket max
- $20 primary care copay, $45 specialist copay
- $10 generic drug copay (no copay available for non-prescription drugs)
The biggest selling point for this plan is the price. For a lot of people, the Bronze 4 plan will be free (for those making around 250% or less of the federal poverty level). For others it will be significantly cheaper than the silver and gold plans.
BCBS Silver 14
Most people have tended to buy silver plans, and Silver 14 has proven to be the most popular combination of price and benefits.
Details:
- $6,650 / $13,300 deductible (individual/family); $7,150 / $14,300 out-of-pocket max
- $20 primary care copay, $50 specialist copay; $50 urgent care copay
- $0-10 copay for generic drugs, $40 copay for preferred brand-name drugs, no copay available for non-preferred drugs.
(Note: If your household income is between 100-250% of the Federal Poverty Level, you’ll be eligible for “cost sharing reductions” that lower your out-of-pocket expenses on silver plans. The details listed above do not factor in these reductions. But when these reductions are factored in, Silver 14 is even better – sometimes ridiculously better!)
BCBS Silver 8
Silver 8 will be slightly more expensive than Silver 14. The main attraction here is the lower copay amount for kids and the lower overall deductible and out-of-pocket max.
Details:
- $5,250 / $10,500 deductible (individual/family); $6,700 / $13,400 out-of-pocket max
- $10 primary care copay for kids under age 20, $25 copay for adults, $40 specialist copay; $50 urgent care copay
- $0-10 copay for generic drugs, $30 copay for preferred brand-name drugs, $100 copay for non-preferred drugs.
BCBS Gold 1
Gold plans cost the most because they have the highest benefit levels. If you’re looking for a gold plan, we generally find Gold 1 to be the most popular option.
Details:
- $2,000 / $4,000 deductible (individual/family); $4,500 / $9,000 out-of-pocket max
- $15 primary care copay, $30 specialist copay, $50 urgent care copay
- $0-12 copay for generic drugs, $35 for preferred brand drugs, $100 for non-preferred brand drugs
Other Considerations
Catastrophic Plans
If you are under age 30 you could choose to purchase a catastrophic plan. These will primarily focus only on catastrophic coverage. The BlueCross catastrophic plan does provide a $25 primary care copay for the first 3 visits. The value here, though, is on price.
HSA-qualified plans
There are several plans on the Marketplace that qualify you to make contributions to a tax-advantaged Health Savings Account. They all have “HD” in the name of the plan. The law dictates that HSA-qualified plans cannot provide any “first dollar” benefits like copays other than preventive care. So these plans are all pretty similar – you’ll just want to find the combination of price with deductible/out-of-pocket costs to find the best fit for you.
Alternatives to Obamacare
If you’re not eligible for subsidies, then the cost of these health insurance plans is really high. With that in mind, some of our clients prefer to look at alternatives. While nothing is perfect, there are a couple of other things you could consider.