Is Obamacare free? Can I get a $0 premium plan?
Some people do pay nothing per month. That is not the same as free coverage, and here is the difference that matters.
Some people qualify for a premium tax credit large enough that certain plans cost nothing per month. It happens, and it is legitimate.
It is not the same as free health care, and treating it that way leads to a bad surprise the first time someone needs care.
How a zero dollar premium happens
The premium tax credit is calculated against a benchmark plan in your area. If your credit is larger than the cost of a particular plan, that plan's premium to you is zero. The credit does not carry over as cash.
This is more common for lower income households and for older applicants, since premiums rise with age while the credit rises to match.
What a zero premium plan still costs you
- A deductible before the plan starts sharing most costs, which on a bronze plan can be substantial
- Copays and coinsurance for care
- An out of pocket maximum, which is your worst case for the year
- Anything from a provider outside the network
The plans that end up at zero premium are usually bronze, which carry the highest deductibles. Someone with a zero premium bronze plan can still face thousands in costs before the plan pays much of anything. That is the trap.
The mistake to avoid
If your income makes you eligible for cost sharing reductions, those apply only to silver plans. They lower your deductible, your copays and your out of pocket maximum, sometimes dramatically.
Taking a zero premium bronze plan instead of a low cost silver plan can save a small amount monthly and cost far more the moment you use care. For anyone eligible for cost sharing reductions, silver is usually the right answer even when bronze is free.
See how the metal levels work.
Being honest about this
We will not tell you that coverage is free. What we can tell you is that many households here pay far less than they expect, and that the difference between choosing well and choosing on premium alone is often larger than the premium itself.
We also cannot promise you a specific dollar amount on a public page. It depends entirely on your household income, size, ages and the plans available at your address.
What to actually compare
- Monthly premium after the credit
- The annual deductible
- The out of pocket maximum, which is your worst case
- Whether your doctors are in network
- Whether your medications are covered and at what tier
- Whether you qualify for cost sharing reductions, and therefore whether silver should win
See deductibles and out of pocket maximums and what Marketplace coverage costs.
Common follow-up questions
Can a Marketplace plan really cost nothing per month?
For some households, yes, when the premium tax credit exceeds a plan's cost. You still pay deductibles, copays and coinsurance when you use care.
Should I take the free plan?
Not automatically. If you qualify for cost sharing reductions, a silver plan usually costs less overall even with a premium, because it lowers your deductible and out of pocket maximum.
Is health care free with a subsidy?
No. Subsidies reduce the premium, and for some incomes also the cost sharing. They do not eliminate deductibles or copays.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. No cost to talk it through.
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