How Much Is Obamacare in Florida? What Changes Your Monthly Premium

There’s no single price for Obamacare in Florida. Your monthly premium depends on your age, ZIP code, household size, tobacco use and the plan level you pick, and, for most people, on your expected income, which sets your tax credit. Many people pay much less than the full price after the credit; others pay the full price. A quote for your ZIP code is the only way to know.

The six things that set your price

Not a factor: your health history, gender or a pre-existing condition.

How the tax credit works: one example

The Marketplace expects you to put a set share of your income toward the second-lowest-cost Silver plan in your area (the benchmark). For the coming plan year, that share ranges from about 2.15% of income at the low end to 10.22% for households from 300% to 400% of the poverty level. Your tax credit pays the rest of the benchmark’s price.

Illustration only: one adult expecting $31,920 (200% of the poverty level) is expected to contribute about 6.78% of income, or $2,164 a year (about $180 a month), toward the benchmark Silver plan. Choose a cheaper plan and you may pay less; choose a richer plan and you pay the difference. Your real numbers depend on your age, ZIP code and plan prices. Income ranges by household size: Obamacare income limits in Florida.

Why did my premium go up?

• Bigger temporary tax credits ended. Congress did not extend them, so many people now get less help, and people above 400% of the poverty level generally get none.
• Insurers raised rates. A KFF review of proposed rates found a median increase of about 15% nationally for the coming plan year.
• Your income estimate changed, or you didn’t update it at renewal.
• You moved up an age band, moved to a new ZIP code, or your plan changed.

If you let your plan renew automatically, you may land in a plan that costs more than one with the same doctors. Read what happens if you do nothing at renewal.

Can the premium be zero?

Some people qualify for a low- or no-premium plan after tax credits, usually Bronze plans or some Silver plans at lower incomes. It depends on your income, household, age and ZIP code. A no-premium plan isn’t always the best value: compare the deductible, the network and your prescriptions first. Metal levels explained: Bronze vs Silver vs Gold in Florida and when Gold can cost less than Silver.

What you pay when you use care

Besides the premium, you pay deductibles, copays and coinsurance until you reach the plan’s out-of-pocket maximum. For the coming plan year, the federal maximum is $12,000 for one person and $24,000 for a family; many plans are lower. If your income is under 250% of the poverty level, a Silver plan can lower those costs through cost-sharing reductions.

Ways to lower what you pay

• Give the Marketplace a careful income estimate and update it when things change.
• Compare every metal level, not just the plan you had last year.
• Check whether your doctors are in the cheaper plans’ networks.
• If you qualify, consider Silver for the extra savings.
• Think you might qualify for Medicaid? We can help with your MyACCESS application for free (we are not DCF). See MyACCESS help.

Open Enrollment runs November 1 to January 15 (enroll by December 15 for January 1 coverage): Florida Open Enrollment help. Overview: Obamacare in Florida.

How much is Obamacare in Florida: FAQ