Blue Cross Ppo Bronze Vs Ppo Bronze Reserve
Affordable Care Act (ACA) bronze plans cover a variety of medical services. Monthly premiums can be lowered significantly if you qualify for tax subsidies—under certain circumstances, your premium rate could go down to $0.1 But are bronze plans the right type of coverage for you? Learn more below.
What Is a Bronze Plan?
A bronze plan is a type of health insurance available on the Affordable Care Act (ACA) marketplace. This plan category describes individual health insurance plans with the least expensive premiums and the highest copay and coinsurance amounts. Additionally, bronze health plans often have higher deductibles.
Because bronze plan monthly premium costs are generally lower—but the out-of-pocket costs (copays, deductibles, etc.) are higher—these plans are well suited for people who are healthy and do not require frequent visits to a doctor.
What Does the Bronze Plan Cover?
All bronze plan coverage must include the 10 essential benefits that are included in all Affordable Care Act-compliant plans, which includes coverage for:
- Prescription drugs.
- Pediatric services: For children, plans include dental, vision, and medical coverage.
- Preventive, wellness, and chronic disease management services.
- Emergency services.
- Hospitalization.
- Mental health and addiction services.
- Pregnancy, maternity, and newborn care.
- Ambulatory services, also known as outpatient care.
- Laboratory services.
- Rehabilitative and habilitative services and devices.
In addition to the above 10 essential benefits, health insurance companies have the opportunity to include additional coverage. You can check a specific bronze plan's coverage by reviewing its Summary of Benefits, where coverage details and costs are listed.
Bronze Plans and Subsidies
Individuals who choose bronze plan coverage can apply for premium tax credits (also known as premium subsidies) to lower costs. Premium tax credits for 2021 and 2022 Affordable Care Act (ACA) plans are available to most households, with no one paying more than 8.5% of their household income toward the cost of the plan.2
The good news is that in 2021, most people who enroll in ACA plans qualify for a premium tax credit. In 2021, 4 million uninsured people qualify for a $0 bronze plan and 4.9 million qualify for a reduced premium.3
However, bronze plans are not eligible for cost-sharing reduction (CSRs) subsidies. This is financial assistance to help with out-of-pocket costs. To use CSRs, you must first be within a certain income amount (up to 250% of the FPL). Then, you have to sign up for coverage with a silver (metal level) plan.
What Is the Average Cost of a Bronze Plan?
For 2021, the average lowest-cost bronze plan is $328 per month before the subsidy.4 Below are the average lowest-cost bronze plans by state in select cities for a 40-year-old nonsmoker earning $30,000 per year in 2021.5
| Lowest-Cost Bronze Plans by State, Estimated Before and After Premium Tax Credits, in 2021 | |||
| State | Major City That Determined Rating | Before Premium Tax Credit | After Premium Tax Credit |
|---|---|---|---|
| Alabama | Birmingham | $401 | $0 |
| Alaska | Anchorage | $435 | $0 |
| Arizona | Phoenix | $342 | $17 |
| Arkansas | Little Rock | $322 | $13 |
| California | Los Angeles | $323 | $7 |
| Colorado | Denver | $273 | $10 |
| Connecticut | Hartford | $368 | $0 |
| Delaware | Wilmington | $400 | $0 |
| District of Columbia | Washington | $337 | $7 |
| Florida | Miami | $339 | $0 |
| Georgia | Atlanta | $348 | $0 |
| Hawaii | Honolulu | $314 | $0 |
| Idaho | Boise | $330 | $0 |
| Illinois | Chicago | $337 | $9 |
| Indiana | Indianapolis | $333 | $4 |
| Iowa | Cedar Rapids | $311 | $0 |
| Kansas | Wichita | $373 | $0 |
| Kentucky | Louisville | $342 | $0 |
| Louisiana | New Orleans | $410 | $0 |
| Maine | Portland | $348 | $15 |
| Maryland | Baltimore | $222 | $0 |
| Massachusetts | Boston | $277 | $4 |
| Michigan | Detroit | $255 | $18 |
| Minnesota | Minneapolis | $251 | $35 |
| Mississippi | Jackson | $407 | $38 |
| Missouri | St. Louis | $347 | $0 |
| Montana | Billings | $330 | $0 |
| Nebraska | Omaha | $439 | $0 |
| Nevada | Las Vegas | $280 | $0 |
| New Hampshire | Manchester | $247 | $9 |
| New Jersey | New Brunswick | $319 | $9 |
| New Mexico | Albuquerque | $236 | $1 |
| New York | New York City | $430 | $0 |
| North Carolina | Charlotte | $350 | $0 |
| North Dakota | Fargo | $273 | $0 |
| Ohio | Cleveland | $280 | $20 |
| Oklahoma | Oklahoma City | $367 | $0 |
| Oregon | Portland | $318 | $0 |
| Pennsylvania | Philadelphia | $306 | $0 |
| Rhode Island | Providence | $231 | $0 |
| South Carolina | Columbia | $328 | $0 |
| South Dakota | Sioux Falls | $454 | $0 |
| Tennessee | Nashville | $340 | $10 |
| Texas | Dallas | $301 | $0 |
| Utah | Salt Lake City | $285 | $0 |
| Vermont | Burlington | $491 | No Data Available |
| Virginia | Richmond | $358 | $0 |
| Washington | Seattle | $280 | $0 |
| West Virginia | Huntington | $596 | $39 |
| Wisconsin | Milwaukee | $338 | $17 |
| Wyoming | Cheyenne | $519 | $0 |
Source: Kaiser Family Foundation Health Insurance Marketplace Calculator. Rates based on 2021 premiums for a 40-year-old nonsmoker making $30,000 per year.
Comparing Bronze Plans to Other Plan Categories (Metal Levels)
There are four categories of ACA marketplace plans. In addition to the bronze plan, there are silver, gold, and platinum plans. Because of the naming structure, these plan categories are often referred to as metal levels. Here is a brief description of the other metal levels:
- Silver plans have premiums that are higher than bronze plans but lower than the other two metal levels. In exchange for a slightly higher premium, the out-of-pocket costs are somewhat less than those of bronze plans. These plans are well suited for people who want a little more coverage than what's offered by bronze health plans. Additionally, people who qualify for subsidies will find the most value in silver plans.
- Gold plans have a higher monthly premium in exchange for lower out-of-pocket costs. The deductibles are usually low. These plans are well suited for people who regularly see a physician or other medical provider.
- Platinum plans have the highest monthly premiums and lowest out-of-pocket costs. The deductibles are usually very low. These plans are well suited for people who go to the doctor frequently and want to know that most of their medical costs will be covered.
Below are the average U.S. monthly premiums for the lowest-cost plan without a tax subsidy in each of the metal levels in 2021.5
| Plan Type | 2021 Monthly Premium |
|---|---|
| Bronze Plan | $328 |
| Silver Plan | $436 |
| Gold Plan | $482 |
| Platinum Plan | To be determined |
Bronze High-Deductible Health Plan With HSA options
A high-deductible health plan (HDHP) is Affordable Care Act (ACA) coverage that enables you to contribute to a health savings account (HSA). You can use HSA funds to pay for deductibles, copayments, coinsurance, and other qualified medical expenses. It is available in most areas of the country.
A plan is considered an HDHP in 2021 for individuals if it has a minimum deductible of $1,400 and maximum out-of-pocket (OOP) costs of $7,000. For families, the minimum deductible is $2,800 with a maximum OOP of $14,000.6
Ready to Enroll in a Bronze Plan?
HealthMarkets can help you compare bronze plans. We make it easy to view tax subsidy amounts and apply for a plan. It's fast, convenient, and comes at no charge to you. Start comparing plans today!
Source: https://www.healthmarkets.com/resources/health-insurance/bronze-plans-all-you-need-to-know/
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