Can I purchase a Platinum policy and also get a premium subsidy?

  • October 31, 2015

Q: I’ve heard that the ACA’s premium subsidies only help a person buy a Silver plan which pays for just 70 percent of average healthcare costs. I would like a Platinum plan – which covers 90 percent – but I also would like a subsidy.

A. You can have both. The size of the subsidy is based on the cost of a silver plan, but you can apply it toward purchasing a platinum policy. If you buy a plan that’s more expensive than the second-lowest-cost Silver plan (the benchmark plan), you’ll pay more than the percentage of your income deemed “affordable” by the ACA. But the total cost of the premium will still be reduced by the same amount of subsidy you’d have received if you had purchased the benchmark plan.

As an example, if the benchmark plan is $300/month and your subsidy amount based on that plan is $200/month, you can apply that $200/month to any Bronze, Silver, Gold, or Platinum plan available in the exchange. If you buy the benchmark plan, you’ll pay $100/month. If you buy a plan that retails for $500/month, you’ll pay $300/month. And if you buy a plan that retails for $225/month, you’ll pay just $25/month.

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