4 Health Insurance Plans Included in the Affordable Care Act

Posted by sanjay on May 9th, 2017

What types of health insurance plans are available through the Affordable Care Act?

What kind of insurance plans will you find on the health insurance marketplace?

The simple answer to both questions is: all kinds.

All plans available are required to offer 10 basic coverage areas, which include hospitalization, outpatient care prescription drugs and laboratory testing.

However, the amount of co-pay and deductibles will vary depending on the type of plan.

All of the available plans have been grouped into four basic categories: Bronze, Silver, Gold and Platinum.

Bronze Plans

Bronze plans will provide coverage for the 10 basic coverage areas, but will, on average, only cover 60% of the expenses; the remaining amount will be paid by you.

Silver Plans

The next level of health insurance plans, Silver, will also provide the 10 basic coverage areas, but will only cover 70% of the expenses.

Gold Plans

The Gold plans, of course, still provide the 10 basic coverage areas, but 80% of expenses are covered.

Platinum Plans

The highest plans, Platinum, will cover 90% of medical expenses.

The general rule is that the lower the premiums, the higher the out-of-pocket costs when you actually need care, and vice versa—the higher the premiums, the lower the out-of-pocket costs when you require care.

Gold and Platinum levels will have lower deductibles, co-payments and co-insurance, but will probably have higher monthly premiums. Bronze and Silver plans will probably have lower premiums, but out-of-pocket costs are likely to be higher.

Catastrophic Plans

Another health plan is called a Catastrophic Plan, which is available for people under the age of 30 and some people with low and/or limited incomes.

These plans typically have lower premiums than comprehensive plans, but cover you only in case you need a great deal of care; in other words, if you had a catastrophe such as a major accident or illness.

Under the conditions of a catastrophic plan, the patient is required to pay ALL medical costs up to a specific amount, usually several thousand dollars. The 10 essential areas are covered, but major health problems—for example, if you were severely injured in an automobile accident or required surgery or were diagnosed with a major illness—are not.

Essentially you are gambling that you won’t have a major injury or illness. This is something people should think through seriously.

For example, treatment for a broken leg can costs ,500 or more. Under a catastrophic plan, your monthly premium is low, but the deductibles and other out-of-pocket costs will be quite high.

Not everyone is eligible for catastrophic plans, but if you are under the age of 30 or have a very low income, it’s an option.

[Source: http://blog.taxact.com/aca-health-insurance-plans/]