Subsidy Eligibility

Understanding Your 2021 OptimaFit® Individual & Family Health Plan Options

Individual health plans offer a variety of price options and are categorized by metallic tiers: Gold, Silver, and Bronze.

Categorizing plans by metallic tier makes it easier for you to compare plans based on their cost and coverage options. If you do not qualify for a subsidy, you may want to consider plans not offered on HealthCare.gov, also known as "Off-Exchange" plans.

This chart provides an overview of health plan tiers to help you determine which metallic plan would be best for you.

Gold Silver Bronze
Monthly Premium $$$ $$ $
Percent of Healthcare Cost Covered 80% 70% 60%
Good If... You want to save on premium costs, while still reducing your out-of-pocket costs. You need to balance monthly premium costs with out-of-pocket costs.* You don't plan to use a lot of healthcare services.

Could You Qualify for a Premium Tax Credit in 2021?

If your income is between 139% and 400% of the Federal Poverty Level, you may get tax credits, also known as subsidies, to help pay for health insurance coverage.

Savings Depends on Income and Household Size

Household Size Income1
1 $17,736 - $51,040
2 $23,963 - $68,960
3 $30,190 - $86,880
4 $36,418 - $104,000
5 $42,645 - $122,720
6 $48,872 - $140,640
7 $55,099 - $158,560
8 $61,326 - $176,480

Things to Consider

If you don't anticipate you will need a lot of healthcare services, you may want to consider a bronze or silver plan for a lower monthly premium.

However, if you or a family member have a serious injury or illness, a bronze or silver plan will require higher out–of–pocket costs for treatment. With a silver or bronze plan, you pay less on a monthly basis but may pay more for treatment. With a gold plan, you pay more on a monthly basis but much less for treatment.

Need Help? Talk to an OptimaFit Plan Advisor 1-800-741-4825.

1Source: https://www.federalregister.gov/documents/2020/01/17/2020-00858/annual-update-of-the-hhs-poverty-guidelines. To verify eligibility and level of subsidy you may qualify for, visit HealthCare.gov.

Get the Best Plan for your Family

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Discover the OptimaFit® difference. Talk to an OptimaFit plan advisor today! Call 1-800-741-4825.

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