Planes de seguro médico

Notas del cálculo

Detalles sobre redondeos, versiones y límites del cálculo.

• Priced where premiums are actually filed. Premiums are filed by county, so a ZIP is resolved to its county and every plan at each metal level is ranked to find the cheapest. Household premiums add each adult plus the three oldest children under 21, as the federal rating rules require. 2,055 counties across 30 HealthCare.gov states are covered; a state running its own exchange is named rather than shown as empty.
• Three scenarios, not one. A premium comparison only answers the healthy-year question. A year with no claims costs the cheapest premium at that metal. The worst year adds the highest individual out-of-pocket maximum filed at that metal in the county, because the landscape file does not pair that premium with one plan’s own maximum. The middle figure caps the care you enter at that same high ceiling.
• What the middle scenario deliberately does not do. It does not model a deductible then coinsurance then a maximum. The published file carries deductibles and out-of-pocket maximums but not the coinsurance rates or covered-service splits that would be needed, so the care you enter is capped rather than run through an invented schedule.
• A credit is dollars, not a percentage. A premium tax credit is a fixed monthly amount. It comes off every metal level alike and is floored at that level’s own premium, so a plan cheaper than the credit costs nothing rather than paying out. That is why a credit narrows the gap between levels rather than scaling it.