Obamacare News Blog

California Platinum Plan Details

California released its Platinum plan premiums and details. Platinum is the Cadillac of plans which has the lowest out-of-pocket maximum of all the new metal plans and your provider covers 90% of your medical costs before you hit that that max. All metal plans much include the ObamaCare 10 essential health benefits and providers must abide by the 80/20 Affordable Care Act Rule, where providers must spend 80% of the plan’s policyholders’ premiums on health care or refund their policyholders.

CA Platinum Plan Breakdown

The California Platinum Plan features no deductible, so policyholders have first-dollar advantage. Below is a chart of Covered California’s Platinum plan (plans may vary by provider):

Benefits Platinum Health Plan*
Deductible $0
Preventive $0
Doctor’s Office Visits $20
Specialist $40
Generic Rx $5 or less
Brand RX $15
Lab Testing $25
X-ray $40
ER Visit $150
Urgent Care $40
Out-of-Pocket Max $4,000/$8,000 (ind/fam)

CA Platinum Plan Premiums

Platinum premiums are the highest per month, with a range of $285 to $687 for a 40 year old. However this does not include ObamaCare federal premium subsidies, which can drop the premium significantly. Remember premiums are based off age, area, and provider. For your specific premium call 800-930-7956.

How Platinum Differs From Other Metal Plans

With the proposed no deductible, and highest monthly premium, Platinum plans are expected to attract the sickest Californians. This could in turn raise premiums drastically in coming years. Even though it has a higher monthly premium, Platinum members will be able to foresee costs because they have a lower out-of-pocket max, and they only pay 10% of their medical costs until then. \ Click here to compare the ObamaCare Bronze plan, Silver plan, Gold plan, and Platinum plan side-by-side.

For further questions call the number above or contact Medicoverage.



Comments and Questions

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Comment from warren bennett on March 11, 2014

i need ins im told by my clinic



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