My mom is trying to get health insurance through the affordable care act but the coverage is terrible and it costs 800-900 dollars a month. How is that affordable and why is it so expensive?

Hey Everyone,

I just read another post asking about health insurance and what we’d do when we fire. As someone self-employed who has been on the ACA since it came out, it hasn’t been a real concern. However, that said, I thought I’d share our numbers.

Important note! Everyone’s numbers will be different. You need to plug in your information to get your costs. Your income (MAGI) strongly factors in - but, so do other factors like state, which company you select, coverage you select, your ages (I think?) - anyway, lots of factors. This is only to give you a frame of reference

Ok, our numbers:

• Two of us, male & female, early 40’s, file taxes jointly

• Expected income next year (MAGI): ~$48k (dividends + residual income)

• Cost for a Gold Plan, $1200 deductible each, $9300 max out of pocket, $25-$60 copays: $715/month

• Cost for a Bronze Plan, $9300 deductible each, $9300 max out of pocket, lol what are copays: $483/month

This is after a significant deduction by almost $1000/month for the income at ~$48k. There were other options as well for coverage - both cheaper & more expensive. The least expensive was ~$83/month after subsidies, and most expensive was above $1.5k. The plans I am discussing were the ones that our doctor accepted and covered the medication we use. It is a HMO. I won’t be giving out our state, location, etc, for privacy purposes. We went with the Gold plan, but have gone with the bronze previously.

If our income ends up being higher than expected, we pay back the difference in subsidies that wouldn’t have been reduced when we pay our annual income tax. It’s best to guess income as accurately as possible and then expect to make up the difference if there’s a change.

If anyone else wants to chime in with their numbers similar to what I did above, I’m sure others would appreciate it. It doesn’t have to be exact. And please, try to stay away from giving out information that might be too private.

Oh, last note - remember ACA plans can’t factor in (or shouldn’t) pre-existing conditions when calculating your premium.

I hope this helps. Again, everyone’s numbers will be different!!