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Silver Plans

Silver plans are another one of four "metal" levels of coverage established by the Affordable Care Act. These plans have proven to be very popular.

Silver plans tend to have affordable monthly insurance premiums. However, their out-of-pocket costs are still more expensive than a Gold or Platinum plan. Specifically, 70% of your medical expenses are paid for by a Silver plan, meaning that you will have to pay for the remaining 30% of these costs.

As with all four plans, your monthly premium could be lowered greatly if you qualify for the Premium Tax Credit. The Premium Tax Credit is like a “discount” applied to your monthly insurance rate and paid for by the government. The main factor in determining your eligibility is your annual household income. Depending on the state you live in, your income must be at or below 4x the Federal Poverty Line to qualify for the Premium Tax Credit.

Additionally, one of the reasons why Silver plans are so popular is that you can also get a similar “discount” on your out-of-pocket costs. Silver plans are the only ones that are eligible for the Cost Sharing Reduction, or when the government helps pay for out-of-pocket health care costs such as coinsurance, copayments, and deductibles. To qualify for the Silver plan’s Cost Sharing Reductions, your income must be at or below 2.5x the Federal Poverty Line.

Remember that the only difference among plans is the amount you pay, not the quality of health care you receive. By law, all four plans must meet the Ten Essential Health Benefits, which includes a free wellness visit and preventative care.

Does it Make Sense to Enroll in a Silver Plan?

Only you can decide what type of plan is best for your individual or family needs. It is important to consider your current health, lifestyle, and medical risk factors. That said, it is always best to think in terms of the total cost of the plan, which is the monthly premium, plus your anticipated out-of-pocket costs when using the insurance.

Silver plans are popular and could be the right choice if you:

  • Are willing to pay a little more for a monthly premium so you can pay a little less out-of-pocket when using medical services.
  • Anticipate needing some non-preventative medical services;
  • Foresee taking some prescription medication;
  • Or, you qualify for Cost Sharing Reductions that lower your out-of-pocket costs. For those who qualify, many find that their total costs of health care tend to be much more affordable. Though they pay a monthly premium that is a little higher than a Bronze plan, the out-of-pocket costs are similar to those of a Gold plan and are much lower.

Keep in mind that no matter which metal level you choose, under Obamacare, all plans have the same maximum out-of-pocket limits. These limits protect you financially, especially if you need a lot of medical care. For 2024, the annual limit is $8,550 for an individual, and $17,100 for a family, including deductibles. Silver plans pays for 70% percent of covered medical expenses before reaching the limit, and then 100% of all covered expenses after reaching the limit.

If you think you will need more regular medical services, it may make more sense to consider a Gold or Platinum plan, especially if you do not qualify for Cost Sharing Reductions.

To start comparing Silver plans, enter your zip code or call (833) 509-1831 to speak with an agent.

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KentuckyHealthplans.org is operated by Quotelab, LLC, which is an independent broker and is not a federal or state Marketplace website. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance on QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

Federal Contracting Statement: Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent [73] organizations which offer [5110] products in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Please note that these numbers provided are not specific to your area but rather represent the number of organizations and the number of products available on a national basis. We will connect you with licensed insurance agents who can provide information about the number of organizations they represent and the number of products they offer in your service area.

Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. QuoteLab, LLC is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on KentuckyHealthplans.org are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

Enrollment in a plan may be limited to certain times of the year unless you qualify for a special [election/enrollment] period or you are in your Medicare Initial Election Period.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

KentuckyHealthplans.org is operated by QuoteLab, LLC, which is an independent broker and is not a federal or state insurance Marketplace or other website. It does not provide access to any federal or state marketplace or exchange. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance are made through QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

This website does not provide information about specific health plans, or enable visitors to obtain insurance quotes, on this website. However, if you provide your information and consent, we will transfer your information to insurance carriers and brokers that may contact you to offer Affordable Care Act (ACA) plans, short-term plans, medical indemnity plans and/or healthcare sharing ministry plans, and we will receive compensation for such transfer. The advertisements appearing on this website are placed by clients from which QuoteLab, LLC receives compensation, and such compensation may impact whether such advertisements appear on this website and the order in which they appear.

KentuckyHealthplans.org is required to comply with all applicable federal law, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website does not provide a complete listing of, or display all data on all Qualified Health Plans being offered in your state or service area through the Marketplace website or the federal Medicare program. To see all available data on Qualified Health Plan options in your state, visit your state Marketplace website, go to the Health Insurance Marketplace website at https://www.healthcare.gov.

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