Your Obamacare costs depend on 5 factors: income, family size, age, location and type of plan. Here’s what you must know before buying insurance.
Source: How Much Will Obamacare Cost Me
This “helpful” article goes on to make its misunderstanding absolutely clear by falsely reporting:
Bronze – Has the lowest premiums, but only pays 60 percent of your health care costs. Pick this plan if you don’t expect a lot of medical bills.
Silver – Pays 70 percent of your covered medical costs, but the premiums are higher than the Bronze plan.
Gold – Pays 80 percent of your costs, with higher premiums than the Silver plan.
Platinum – Pays 90 percent of your costs, but has the highest monthly premiums. It will make sense to pick this plan if you have a chronic health condition.
All of the above is 100% false news reporting. Fake news reporters did not understand that the concept of 60%, 70% payout and so forth refers to the entire pool of insured and does not apply to any particular individual.
Because ACA policies have a maximum “out of pocket” limit, the higher your health expenses, the greater the percentage that is paid for by insurance.
For example, let’s say you have a common Bronze policy with a $13,,000 out of pocket maximum limit and $100,000 in expenses. Your costs are going to be near $13,000 – once your expenses exceed the out of pocket maximum, the remainder is paid by the insurer. In this example, the insurer has paid almost 90% of your expenses, not the 60% claimed by the fake news report.
On the other hand, if your deductible is $8,000 (a typical value in ACA policies) and you have $5,000 of medical expenses, your costs are 100% and the insurers’ are 0%. As you can see, the implied 60% coverage by the insurer is meaningless.
So what does the “60% of costs” mean?
The 60% refers to the costs of the entire insurance pool. For the pool of Bronze customers, their overall payout will be about 60% of total costs incurred by everyone in the pool combined. Let’s say there are 1,000 customers in this pool. If all of their costs were added together, the amount covered by insurance would be 60% of their combined costs. But this 60% value DOES NOT APPLY TO INDIVIDUALS. Some will be less and some will be more, much more, and shown in the example, above.
Consider the role that false reporting has on how the public views public policy. False reporting shapes the public’s perception, leading, in turn, to public opinion polls purporting to show “what the public believes” is true (as we have noted before, the only value of a public opinion poll is to measure the effectiveness of propaganda).
A Pulitzer Prize winning reporter, working for a nationally recognized newspaper, also reported on this topic incorrectly. I sent him a link to the U.S. Department of Health and Human Services page that explained what the 60% actually meant. His newspaper never issued a correction to his false news report. I no longer consider his paper a reliable source of news.