Obamacare: Platinum, Gold, Silver, Bronze Coverageby Denise Early on May. 29, 2013, under Health
Under the current system (2013), picking a health insurance plan is very complicated. Plan design and cost-sharing vary widely, and some people end up choosing a $10,000 deductible in order to get an affordable premium.
Do you want a plan with unlimited doctor visits for a $50 co-pay? That will cost you big time. A plan with just three doctor visits per year for a co-pay will cost you less…but will get expensive if your health changes for the worse.
Do you want your deductible to be $1,000? That will cost you. Most people choose a $5,000 deductible to keep their monthly premium affordable.
If you want maternity coverage in your health insurance…. forget about it. Most health insurance for individuals and families does not cover maternity. Some companies will sell you a supplemental maternity policy, but it is expensive.
Obamacare will make individual and family health insurance easier to understand.
Starting in January 2014, health insurance plans will be standardized. There will be four coverage levels: Platinum, Gold, Silver, and Bronze. A Platinum plan will offer the most coverage and lowest cost-sharing – and the highest premium. A Bronze plan will have the highest levels of cost-sharing and the lowest premium.
Platinum plans will cover 90% of a person’t health care costs.
Gold plans will cover 80% of a person’t health care costs.
Silver plans will cover 70% of a person’t health care costs.
Bronze plans will cover 60% of a person’t health care costs.
Catastrophic plans will be available to people under 30. These plans will cover essential health benefits, but will have high deductibles.
Under Obamacare, the highest deductible allowed will be $6,350 per year for individuals and $12,700 per year for families.
Because of Obamacare, all health insurance plans now cover preventive screening services at no cost to the patient. The preventive screening list includes mammograms, certain vaccinations, and blood tests for diabetes and cholesterol. Co-pays and deductibles do not apply to theses services.
Essential health benefits must be covered by all plans.
Individual and family health insurance will be more like employer health plans because they will cover more services such as:
- Ambulatory patient services, such as doctor’s visits and outpatient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Most of the information in this post comes from the Georgetown University Health Policy Institute.