Silver Plans are the marketplace standard plan. The second lowest cost Silver plan in a state is used as the benchmark plan when determining subsidies.
Silver plans provide an average cost sharing value (known as Actuarial Value AV) of 70%. This means that a Silver plan must cover an average of 70% of all that plans enrollees covered out-of-pocket costs (based on a standard population). This does not mean that 70% of actual costs will be covered for any one given person. In fact, a small minority of policy holders will account for the majority of costs. So actuarial value should always be looked at as a sign of how good a plan’s cost sharing is, not as a literal amount.
Silver Plans and Subsidies
The biggest perk of Silver Plans is that they can be paired with both Tax Credits and Cost Sharing Reduction Subsidies. They are the only plan that can pair with Cost Sharing Reduction subsidies. Given this anyone who qualifies for Cost Sharing Reduction Subsidies (100%-250% of the Federal Poverty Level) will most likely find the best value plan in the Silver metal level.
Not Every Silver Plan is the Same
Depending upon your region and your plan a Silver plan can have a wide range of costs, benefits, and networks. Remember it only has to have an average value of 70%. Insurers can use a number of different cost sharing arrangements to come to this number.
Also, there is no hard-and-fast rule for what benefits and cost sharing a plan must offer beyond the minimum requirements. This means a plan can have a narrow network, or only cover certain drugs, or limit the amount of times you can access a service, or provide high cost sharing in one area and low cost sharing in another and still be considered a Silver plan.
one quick question,
above the 250% of federal poverty can not get the Cost Sharing Reduction?
Correct. Income above 250% of the FPL is eligible for a subsidy but not a Cost Sharing Reduction.
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