Health Insurance Plans in South Carolina
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| Plan Name | On or Off Exchange | Plan eligible for subsidy? | Metal Level | Deductible (individual/family) | Out-of-pocket Max (individual/family) | |
|---|---|---|---|---|---|---|
| BlueEssentials HD Bronze 3 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $5,400 / $10,800 | $7,500 / $15,000 | Price & Details | |
| BlueEssentials Bronze 4 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,200 / $14,400 | $9,450 / $18,900 | Price & Details | |
| BlueEssentials HD Bronze 5 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $7,500 / $15,000 | Price & Details | |
| Elite Bronze + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Bronze | $0 / $0 | $9,250 / $18,500 | Price & Details | |
| BlueEssentials Bronze 6 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $0 / $0 | $8,900 / $17,800 | Price & Details | |
| Blue VirtuConnect Bronze 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| BlueEssentials Standard Expanded Bronze by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Everyday Bronze by Absolute Total Care, Inc | Obamacare | Bronze | $8,450 / $16,900 | $9,250 / $18,500 | Price & Details | |
| Elite Bronze by Absolute Total Care, Inc | Obamacare | Bronze | $0 / $0 | $9,250 / $18,500 | Price & Details | |
| Standard Expanded Bronze by Absolute Total Care, Inc | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Everyday Bronze + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Bronze | $8,450 / $16,900 | $9,250 / $18,500 | Price & Details | |
| Standard Expanded Bronze + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Ambetter Virtual Access Bronze (Virtual PCP selection required) by Absolute Total Care, Inc | Obamacare | Bronze | $7,000 / $14,000 | $8,550 / $17,100 | Price & Details | |
| First Choice Next Bronze Classic 9450 + No-Referrals by First Choice Next | Obamacare | Bronze | $9,450 / $18,900 | $9,450 / $18,900 | Price & Details | |
| First Choice Next Expanded Bronze Classic 7500 + No-Referrals by First Choice Next | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| UHC Bronze Value by UnitedHealthcare | Both | Bronze | $8,250 / $16,500 | $9,450 / $18,900 | Price & Details | |
| UHC Bronze Copay Focus $0 Indiv Med Ded by UnitedHealthcare | Both | Bronze | $0 / $0 | $9,450 / $18,900 | Price & Details | |
| UHC Bronze Value HSA by UnitedHealthcare | Both | Bronze | $6,700 / $13,400 | $8,050 / $16,100 | Price & Details | |
| First Choice Next Expanded Bronze Premier 3500 + No-Referrals by First Choice Next | Obamacare | Bronze | $3,500 / $7,000 | $9,450 / $18,900 | Price & Details | |
| Blue Cooper Bronze 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,900 / $15,800 | $8,850 / $17,700 | Price & Details | |
| Blue Cooper Standard Expanded Bronze by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Connect Bronze 8500 Indiv Med Deductible by Cigna Healthcare of South Carolina | Obamacare | Bronze | $8,500 / $17,000 | $9,450 / $18,900 | Price & Details | |
| Connect Bronze 6500 Indiv Med Deductible by Cigna Healthcare of South Carolina | Obamacare | Bronze | $6,500 / $13,000 | $9,450 / $18,900 | Price & Details | |
| Connect Bronze 0 Indiv Med Deductible by Cigna Healthcare of South Carolina | Obamacare | Bronze | $0 / $0 | $9,450 / $18,900 | Price & Details | |
| Connect Bronze 4500 Indiv Med Deductible Enhanced Diabetes Care by Cigna Healthcare of South Carolina | Obamacare | Bronze | $4,500 / $9,000 | $9,450 / $18,900 | Price & Details | |
| Connect Bronze CMS Standard by Cigna Healthcare of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Blue Pee Dee Bronze 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,900 / $15,800 | $8,850 / $17,700 | Price & Details | |
| Blue Pee Dee Standard Expanded Bronze by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Blue Reedy Bronze 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,900 / $15,800 | $8,850 / $17,700 | Price & Details | |
| Blue Reedy Standard Expanded Bronze by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Blue Congaree Bronze 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,900 / $15,800 | $8,850 / $17,700 | Price & Details | |
| Blue Congaree Standard Expanded Bronze by Blue Cross and Blue Shield of South Carolina | Obamacare | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| UHC Bronze Essential by UnitedHealthcare | Both | Bronze | $6,350 / $12,700 | $9,450 / $18,900 | Price & Details | |
| UHC Bronze Standard by UnitedHealthcare | Both | Bronze | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| BlueEssentials Silver 7 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,300 / $10,600 | $9,450 / $18,900 | Price & Details | |
| BlueEssentials Silver 38 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $6,500 / $13,000 | $9,450 / $18,900 | Price & Details | |
| BlueEssentials Silver 14 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $6,900 / $13,800 | $9,400 / $18,800 | Price & Details | |
| BlueEssentials Silver 39 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $0 / $0 | $8,700 / $17,400 | Price & Details | |
| Blue VirtuConnect Silver 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| BlueEssentials Standard Silver by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Silver 1 by MOLINA HEALTHCARE OF SOUTH CAROLINA, INC | Obamacare | Silver | $5,000 / $10,000 | $7,850 / $15,700 | Price & Details | |
| Silver 8 by MOLINA HEALTHCARE OF SOUTH CAROLINA, INC | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Silver 12 by MOLINA HEALTHCARE OF SOUTH CAROLINA, INC | Obamacare | Silver | $7,000 / $14,000 | $9,450 / $18,900 | Price & Details | |
| Silver 1 with Adult Vision Services by MOLINA HEALTHCARE OF SOUTH CAROLINA, INC | Obamacare | Silver | $5,000 / $10,000 | $7,850 / $15,700 | Price & Details | |
| Everyday Silver by Absolute Total Care, Inc | Obamacare | Silver | $6,500 / $13,000 | $8,400 / $16,800 | Price & Details | |
| Clear Silver by Absolute Total Care, Inc | Obamacare | Silver | $5,400 / $10,800 | $5,400 / $10,800 | Price & Details | |
| Focused Silver by Absolute Total Care, Inc | Obamacare | Silver | $6,300 / $12,600 | $8,000 / $16,000 | Price & Details | |
| Standard Silver by Absolute Total Care, Inc | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Everyday Silver + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Silver | $6,500 / $13,000 | $8,400 / $16,800 | Price & Details | |
| Clear Silver + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Silver | $5,400 / $10,800 | $5,400 / $10,800 | Price & Details | |
| Focused Silver + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Silver | $6,300 / $12,600 | $8,000 / $16,000 | Price & Details | |
| Standard Silver + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Ambetter Virtual Access Silver (Virtual PCP selection required) by Absolute Total Care, Inc | Obamacare | Silver | $5,700 / $11,400 | $7,400 / $14,800 | Price & Details | |
| UHC Silver Standard by UnitedHealthcare | Both | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| UHC Silver Advantage by UnitedHealthcare | Both | Silver | $2,750 / $5,500 | $9,450 / $18,900 | Price & Details | |
| UHC Silver Copay Focus $0 Indiv Med Ded by UnitedHealthcare | Both | Silver | $0 / $0 | $9,450 / $18,900 | Price & Details | |
| First Choice Next Silver Classic 5900 + No-Referrals by First Choice Next | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| First Choice Next Silver Premier 0 + No-Referrals by First Choice Next | Obamacare | Silver | $0 / $0 | $9,400 / $18,800 | Price & Details | |
| Blue Cooper Silver 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $7,000 / $14,000 | $9,300 / $18,600 | Price & Details | |
| Blue Cooper Silver 2 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $8,000 / $16,000 | $9,300 / $18,600 | Price & Details | |
| Blue Cooper Standard Silver by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Blue Cooper HD Silver 3 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,500 / $11,000 | $5,500 / $11,000 | Price & Details | |
| Connect Silver 7500 Indiv Med Deductible by Cigna Healthcare of South Carolina | Obamacare | Silver | $7,500 / $15,000 | $9,400 / $18,800 | Price & Details | |
| Connect Silver 4300 Indiv Med Deductible by Cigna Healthcare of South Carolina | Obamacare | Silver | $4,300 / $8,600 | $9,250 / $18,500 | Price & Details | |
| Connect Silver 8500 Indiv Med Deductible by Cigna Healthcare of South Carolina | Obamacare | Silver | $8,500 / $17,000 | $8,500 / $17,000 | Price & Details | |
| Connect Silver 0 Indiv Med Deductible by Cigna Healthcare of South Carolina | Obamacare | Silver | $0 / $0 | $9,450 / $18,900 | Price & Details | |
| Connect Silver CMS Standard by Cigna Healthcare of South Carolina | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Blue Pee Dee Silver 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $7,000 / $14,000 | $9,300 / $18,600 | Price & Details | |
| Blue Pee Dee Silver 2 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $8,000 / $16,000 | $9,300 / $18,600 | Price & Details | |
| Blue Pee Dee Standard Silver by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Blue Pee Dee HD Silver 3 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,500 / $11,000 | $5,500 / $11,000 | Price & Details | |
| Blue Reedy Silver 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $7,000 / $14,000 | $9,300 / $18,600 | Price & Details | |
| Blue Reedy Silver 2 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $8,000 / $16,000 | $9,300 / $18,600 | Price & Details | |
| Blue Reedy Standard Silver by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Blue Reedy HD Silver 3 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,500 / $11,000 | $5,500 / $11,000 | Price & Details | |
| Blue Congaree Silver 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $7,000 / $14,000 | $9,300 / $18,600 | Price & Details | |
| Blue Congaree Silver 2 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $8,000 / $16,000 | $9,300 / $18,600 | Price & Details | |
| Blue Congaree Standard Silver by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,900 / $11,800 | $9,100 / $18,200 | Price & Details | |
| Blue Congaree HD Silver 3 by Blue Cross and Blue Shield of South Carolina | Obamacare | Silver | $5,500 / $11,000 | $5,500 / $11,000 | Price & Details | |
| UHC Silver Value by UnitedHealthcare | Both | Silver | $3,500 / $7,000 | $9,450 / $18,900 | Price & Details | |
| BlueEssentials Gold 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $2,500 / $5,000 | $4,900 / $9,800 | Price & Details | |
| BlueEssentials HD Gold 3 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $3,400 / $6,800 | $3,400 / $6,800 | Price & Details | |
| BlueEssentials Gold 4 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $3,000 / $6,000 | $6,600 / $13,200 | Price & Details | |
| BlueEssentials Gold 5 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $250 / $500 | $9,450 / $18,900 | Price & Details | |
| Blue VirtuConnect Gold 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| BlueEssentials Standard Gold by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Gold 1 by MOLINA HEALTHCARE OF SOUTH CAROLINA, INC | Obamacare | Gold | $1,550 / $3,100 | $8,100 / $16,200 | Price & Details | |
| Gold 8 by MOLINA HEALTHCARE OF SOUTH CAROLINA, INC | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Gold 1 with Adult Vision Services by MOLINA HEALTHCARE OF SOUTH CAROLINA, INC | Obamacare | Gold | $1,550 / $3,100 | $8,100 / $16,200 | Price & Details | |
| Complete Gold by Absolute Total Care, Inc | Obamacare | Gold | $1,450 / $2,900 | $7,500 / $15,000 | Price & Details | |
| Everyday Gold by Absolute Total Care, Inc | Obamacare | Gold | $750 / $1,500 | $7,500 / $15,000 | Price & Details | |
| Elite Gold by Absolute Total Care, Inc | Obamacare | Gold | $0 / $0 | $5,500 / $11,000 | Price & Details | |
| Standard Gold by Absolute Total Care, Inc | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Complete Gold + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Gold | $1,450 / $2,900 | $7,500 / $15,000 | Price & Details | |
| Everyday Gold + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Gold | $750 / $1,500 | $7,500 / $15,000 | Price & Details | |
| Elite Gold + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Gold | $0 / $0 | $5,500 / $11,000 | Price & Details | |
| Standard Gold + Vision + Adult Dental by Absolute Total Care, Inc | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| UHC Gold Standard by UnitedHealthcare | Both | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| UHC Gold Copay Focus $0 Indiv Med Ded by UnitedHealthcare | Both | Gold | $0 / $0 | $8,000 / $16,000 | Price & Details | |
| UHC Gold Advantage by UnitedHealthcare | Both | Gold | $1,200 / $2,400 | $7,500 / $15,000 | Price & Details | |
| UHC Gold Advantage+ (Dental + Vision) by UnitedHealthcare | Both | Gold | $1,200 / $2,400 | $7,500 / $15,000 | Price & Details | |
| First Choice Next Gold Classic 1500 + No-Referrals by First Choice Next | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Blue Cooper Gold 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $250 / $500 | $9,450 / $18,900 | Price & Details | |
| Blue Cooper Standard Gold by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Connect Gold CMS Standard by Cigna Healthcare of South Carolina | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Blue Pee Dee Gold 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $250 / $500 | $9,450 / $18,900 | Price & Details | |
| Blue Pee Dee Standard Gold by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Blue Reedy Gold 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $250 / $500 | $9,450 / $18,900 | Price & Details | |
| Blue Reedy Standard Gold by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| Blue Congaree Gold 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $250 / $500 | $9,450 / $18,900 | Price & Details | |
| Blue Congaree Standard Gold by Blue Cross and Blue Shield of South Carolina | Obamacare | Gold | $1,500 / $3,000 | $8,700 / $17,400 | Price & Details | |
| BlueEssentials Catastrophic 1 by Blue Cross and Blue Shield of South Carolina | Obamacare | Catastrophic | $9,450 / $18,900 | $9,450 / $18,900 | Price & Details | |
| Blue Option Catastrophic by BlueChoice HealthPlan | Off | Catastrophic | $9,450 / $18,900 | $9,450 / $18,900 | Price & Details | |
| Blue Option Bronze 8000 by BlueChoice HealthPlan | Off | Bronze | $8,000 / $16,000 | $9,300 / $18,600 | Price & Details | |
| Blue Option Bronze 7200 HD by BlueChoice HealthPlan | Off | Bronze | $7,200 / $14,400 | $7,200 / $14,400 | Price & Details | |
| Blue Option Bronze 6500 by BlueChoice HealthPlan | Off | Bronze | $6,500 / $13,000 | $9,300 / $18,600 | Price & Details | |
| Blue Option Silver 2250 by BlueChoice HealthPlan | Off | Silver | $2,250 / $4,500 | $7,500 / $15,000 | Price & Details | |
| Blue Option Silver 3200 by BlueChoice HealthPlan | Off | Silver | $3,200 / $6,400 | $8,100 / $16,200 | Price & Details | |
| Blue Option Silver 4500 by BlueChoice HealthPlan | Off | Silver | $4,500 / $9,000 | $8,900 / $17,800 | Price & Details | |
| Blue Option Silver 7350 by BlueChoice HealthPlan | Off | Silver | $7,350 / $14,700 | $9,200 / $18,400 | Price & Details | |
| Blue Option Silver 6250 by BlueChoice HealthPlan | Off | Silver | $6,250 / $12,500 | $8,600 / $17,200 | Price & Details | |
| Blue Option Silver 5550 by BlueChoice HealthPlan | Off | Silver | $5,550 / $11,100 | $7,400 / $14,800 | Price & Details | |
| Blue Option Silver 5225 HD by BlueChoice HealthPlan | Off | Silver | $5,225 / $10,450 | $5,225 / $10,450 | Price & Details | |
| Blue Option Silver 8600 by BlueChoice HealthPlan | Off | Silver | $8,600 / $17,200 | $8,600 / $17,200 | Price & Details | |
| Blue Option Gold 1500 by BlueChoice HealthPlan | Off | Gold | $1,500 / $3,000 | $5,000 / $10,000 | Price & Details | |
| Blue Option Gold 3200 HD by BlueChoice HealthPlan | Off | Gold | $3,200 / $6,400 | $3,200 / $6,400 | Price & Details |
Help with Obamacare & Off-Exchange Plans Sign Up
After using a subsidy tax credit, you may be eligible for Obamacare plans as low as $0.
Licensed insurance agents at our trusted partner help people apply for a subsidy and sign up for Obamacare plans available on healthcare.gov or other State exchange marketplaces.
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Learn More About Obamacare and Off-Exchange Plans in South Carolina
What are Obamacare Health Insurance Plans?
Obamacare health insurance plans are plans which are eligible for reduced costs with a subsidy tax credit. Obamacare plans are only offered through the federal government exchange marketplace healthcare.gov or some States have their own exchange marketplace website. Although plans are only offered through the exchange marketplaces, the federal government allows certified brokers, agents, and web brokers to help you enroll in an Obamacare plan and apply for a subsidy.
What are Off-Exchange Health Insurance Plans?
Off-Exchange health insurance plans are plans which are available outside of the federal government exchange marketplaces. Off-Exchange plans existed before Obamacare. For example, if someone did not have access to a health insurance plan through work, they may have purchased an Off-Exchange plan offered on the Individual Market.
You can enroll in an Off-Exchange plan through a broker, agent, web broker, or by contacting the insurance company directly.
What’s the difference between Obamacare plans and Off-Exchange plans?
The main difference between Obamacare plans and Off-Exchange plans is that only Obamacare plans are eligible for a subsidy tax credit to reduce costs.
Otherwise there are not many other differences between Obamacare plans and Off-Exchange plans. Plan design, coverage, and rates are similar and both sets of plans must adhere to federal government regulations. In fact, there are many plans which are available as both Obamacare plans and as Off-Exchange plans.
Can a plan be both an Obamacare and Off-Exchange plan?
Yes, a plan can be available as both an Obamacare and an Off-Exchange plan.
On the other hand, some plans are only offered as Obamacare plans while other plans are only offered as Off-Exchange plans.
Do plans which are both Obamacare and Off-Exchange plans cost the same price?
Yes, by law a plan which is offered as both an Obamacare plan and an Off-Exchange plan must be sold at the same price. In addition, broker, agents, and web brokers are required to sell plans at the same market price. However, keep in mind that only Obamacare plans are eligible for a subsidy to reduce the monthly premium price.
Who is eligible for Obamacare and Off-Exchange plans?
Technically everyone is eligible for Obamacare plans and Off-Exchange plans. The real question is - who is eligible for a subsidy tax credit? - which can only be used to reduce the costs of Obamacare plans. Note that even if you are not eligible for a subsidy tax credit, you are still allowed to purchase an Obamacare plan at the full price.
What is the Obamacare Subsidy (Tax Credit)?
The Obamacare subsidy is really a tax credit, and it is formally known as the Advanced Premium Tax Credit (APTC). Typically people receive a tax credit at the end of the year when filing taxes, but this tax credit can be received “in advance”, during the year, to reduce the monthly premium costs of an Obamacare health insurance plan.
You must complete an official federal government application to learn your subsidy amount. Everyone’s amount will be different. The calculation for the subsidy amount can be quite complicated. It is based on several different factors, but household income is the main factor. We recommend using our tool to estimate your subsidy amount.
Search Obamacare plans and estimate subsidy amount
Who is eligible to receive an Obamacare Subsidy (Tax Credit)
To be eligible for a subsidy to reduce the monthly premium costs of Obamacare plans, you must meet the following requirements.
- Income requirements based on household size and household income. As examples, earn less than $48,240 for an individual and less than $98,400 for a family of four
- Not eligible for other federal government sponsored insurance, such as Medicare or Medicaid
- Do not have access to a health insurance plan from your employer which meet federal government coverage and affordability requirements
- File taxes or be claimed as a spouse or dependent on taxes. Married couples are required to file taxes jointly.
- Not be incarcerated
- Be legally present in the United States
Why should I consider Off-Exchange plans?
Off-Exchange plans may provide you with additional options compared to available Obamacare plans. If you are not eligible for a subsidy, or only eligible for a small subsidy amount, Off-Exchange plans may still be an affordable option for you.
A second reason for considering Off-Exchange plans is that your favorite doctor may only accept a plan which is available as an Off-Exchange plan. We recommend researching provider networks when considering health insurance plans. We provide links to official provider directories, or doctor lookups, on Health Plan Radar.
In addition, some health insurance companies have been leaving the Obamacare plan market, but they may still offer Off-Exchange plans. Your preferred insurance company may still offer plans on the Off-Exchange market.
How do I choose an Obamacare plan or Off-Exchange plan which is best for me and my family?
There are several health insurance concepts you should understand before choosing a plan that’s best for you, including premium price, out-of-pocket costs, deductibles, and plan metal levels. Visit our choosing a plan FAQ page to learn more.
FAQs - Choosing an Obamacare or Off-Exchange Health Insurance Plan