Major Changes to the ACA Silver 70 Plans in 2022 in California


Starting in 2022, we are seeing some positive changes to the Silver 70 plan benefits for both Covered CA & off-exchange (direct-to-carrier) plans. The Silver plans are the most popular plan selection of the 4 metal tier options (Bronze, Silver, Gold & Platinum). The biggest change to the Silver 70 plan for 2022 is the reduction of the annual prescription deductible from $300 in 2021 to only $10 in 2022. This is wonderful news as one of the biggest complaints about the Silver plans has been its high drug deductible. Once you have met your $10 drug deductible, you would then pay the below copays for a month’s supply, depending on the drug tier (please review your insurance company’s drug formulary to find each prescription’s drug tier).

Prescription Copays in 2022 (monthly supply)

Tier 1 – $15 vs $16 in 2021

Tier 2 – $55 vs $60 in 2021

Tier 3 – $85 vs $90 in 2021

Tier 4 – 20% up to $250 for a month’s supply (same as in 2021)

There are some additional changes to the Silver 70 plan for 2022. The primary care, urgent care, and mental health visit copays are dropping from $40 to $35 while the specialist visit copay is also dropping from $80 to $70. The medical deductible is also dropping $300 from $4,000 in 2021 to $3,700 in 2022. It is important to note that outpatient surgery, advanced imaging & radiology, x-rays, blood tests, ER visits do not apply to the medical deductible. Inpatient/hospitalization services do apply to the medical deductible after which a member would pay 20% coinsurance until they reach their annual out-of-pocket maximum of $8,200.

If you have any questions about your health insurance plan changes for next year, please do not hesitate to contact us. At Solid Health Insurance, we strive to find the right health, dental, vision, life, and long-term care insurance which best fits your budget and medical needs. Please contact us at info@solidhealthinsurance or at 310-909-6135 to go over your 2022 renewal options.





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