ACA Marketplace Health Plans: What to Expect
Open enrollment is almost here! Have you thought about your out-of-pocket costs after you pay your monthly health insurance premium?
Make sure to choose your plan before Open Enrollment ends on January 15!
Let’s take a look at what to expect based on your plan in terms of deductibles and other out-of-pocket costs like copays
ACA Marketplace Plan Estimated Maximum Out-of-Pocket Costs for 2025 Plan
Bronze Plan* – Expect an out-of-pocket maximum of $18,400.
Silver Plan* – Expect an out-of-pocket maximum of $18,400.
Gold Plan* – Expect an out-of-pocket maximum of $18,400.
*Estimated costs are based on a family of four (M-35, F-34, Ch1-15, Ch2-6), with an annual household income of $92,000 and an $844 tax credit
Understand that until you meet your deductible, you will be paying out of pocket for the cost of care until your deductible is met. Even after meeting your deductible, you will still have out-of-pocket expenses at the time of service in the forms of co-pays. Health insurance does not cover the total cost of care until you meet your out-of-pocket maximum.
Pro Tip: By purchasing a Hooray Health plan for about $40/month or $10/week, you can supplement your health insurance and save money on out-of-pocket costs like deductibles and copays.
ACA Healthcare Exchange Important Open Enrollment Dates
November 1st – Open Enrollment begins
December 15th – Last day to enroll or change plans for January 1st coverage
January 1st – Coverage begins for plans with enrollment completed by December 15th
January 15th – Open enrollment ends
February 1st – Coverage begins for plans with enrollment completed by January 15th
Here’s an example. Think about the cost of going to an urgent care center for a sinus infection. The average national cost for a visit like this is about $140. Let’s take a look at your out-of-pocket costs under three scenarios:
- No Hooray Health – before you meet your deductible
- No Hooray Health – after you meet your estimated deductible based off 2024 ACA Plans
- With Hooray Health regardless of if you met your deductible
| Plan Type | Treatment Cost | You Pay Before Meeting Estimated Deductible | You Pay After Meeting Estimated Deductible | You Pay With Hooray Health Plan |
|---|---|---|---|---|
| Bronze | $142.00 | $142.00 | $85.20 | $25.00 |
| Silver | $142.00 | $142.00 | $56.80 | $25.00 |
| Gold | $142.00 | $142.00 | $28.40 | $25.00 |
As you can see, your in-network urgent care visit will be only $25 (your visit fee) with a Hooray Health plan. All you need to do is show your card at check-in and pay the $25 visit fee. Talk about an easy and convenient experience.
Download the Hooray Health 365 App to explore additional details.
To speak to a representative,
please call (855) 479-4017
Take a look at Hooray Health’s supplemental insurance plans.
Sources:
https://healthcare.gov/quick-guide/dates-and-deadlines/
https://accesshealthct.com/annual-open-enrollment/
https://kff.org/report-section/ehbs-2023-section-8-high-deductible-health-plans-with-savings-option/
https://forbes.com/advisor/health-insurance/urgent-care-cost/
The health plan categories: Bronze, Silver, Gold & Platinum | HealthCare.gov
https://woodruffsawyer.com/insights/2025-hsa-limits-released