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I Can’t Afford My Obamacare Deductible. Now What?

I Can’t Afford My Obamacare Deductible. Now What?

Posted Jan 15, 2016 by Jenifer Dorsey

What's the average deductible for an Obamacare health insurance plan? $3,037 for silver plans, which are the most commonly purchased, sold on HealthCare.gov as well as California and New York's respective state-based exchanges.[1] And a New York Times review found that more than half of plans for sale through HealthCare.gov have a deductible of $3,000 or more.[2]

As The New York Times points out, the Obama administration has touted low health insurance premiums available through the Affordable Care Act’s marketplaces (i.e., state-based and federally facilitated exchanges); however, many consumers are experiencing sticker shock when they get sick and need to use their coverage.

If you find yourself in a position where you can’t afford your Obamacare deductible, you have some options that may be able to help.

Cost-sharing reductions may lower what you pay

First, you may want to revisit your coverage before 2016 open enrollment ends on Jan. 31, 2016—you may still have time to switch plans. Did you purchase your Obamacare plan through a state-based or federally facilitated exchange? Did you apply for income-based financial assistance?

In addition to premium tax credits that can reduce what you pay for coverage each month, you may qualify for cost-sharing reductions that help lessen your healthcare costs beyond premium, including your deductible, coinsurance, copayment and out-of-pocket limit.

Only silver plans purchased through a state-based or federally facilitated exchange are eligible for cost-sharing reductions. You must also earn between 100 and 250 percent of the federal poverty level.

Might I qualify for a subsidy?

Accessorize your health plan with supplemental health products

It may seem counterintuitive to spend more money, but you might also consider supplemental products that can help with your out-of-pocket healthcare expenses. You can purchase supplemental coverage whether or not you qualify for cost-sharing reductions, and whether you buy your health insurance plan from an Obamacare marketplace or the private market.

Two supplemental benefits options available to individuals and families through healthedeals.com include:

1. Metal Gap and Metal Gap 2 – These products are considered medical gap insurance. Metal Gap plans cost about $1 per day, and the cost of Metal Gap 2 plans varies. In return, they pay a lump sum  benefit when a covered accident or illness occurs—the amount depends on the coverage you select. How you use the payment is up to you.

You can use the benefit toward your deductible, non-covered medical bills, household expenses, childcare and more. Plan availability depends on what state you live in. Click here for an example of how Metal Gap and Metal Gap 2 work.

What's Metal Gap?                        What's Metal Gap 2?

2. The Telemedicine package with a patient advocacy benefit –Telemedicine is not insurance, but it is a supplemental product that can help reduce the cost of care when you see a doctor and can also save you a trip to the clinic. With the Telemedicine package available from healthedeals.com, you can receive over-the-phone healthcare consultations for minor ailments, such as a cold, sinus infection, allergies, and pink eye, to name a few—anytime of day, any day of the year, anywhere you are with a phone signal.


The Telemedicine package does not require you to use a network, and you pay $15 per consultation. In addition, you receive access to a patient advocacy benefit that can help you should you find yourself with large out-of-pocket expenses due to a high-deductible health plan, out-of-network charges or expensive prescription drugs.

Try Telemedicine

Be sure to consult a health insurance professional who can assist you in selecting ACA-compliant health insurance as well as determine which supplemental benefits might be helpful to you and your family. Call the number at the top of your screen to speak with a health insurance producer (i.e., agent or broker) today.


Legal Disclaimers


[1] Mangan, Dan. "Obamacare Plans Get More Restrictive and Deductibles Get Pricer in 2018." CNBC. Nov. 30, 2017. https://www.cnbc.com/2017/11/30/obamacare-plans-get-narrower-and-deductibles-get-pricier-in-2018.html

[2] Pear, Robert. “Many Say High Deductibles Make health Insurance Law All but Useless.” The New York Times. Nov. 14, 2015. http://www.nytimes.com/2015/11/15/us/politics/many-say-high-deductibles-make-their-health-law-insurance-all-but-useless.html?_r=0