Platinum Healthcare Exchange Plan Details
What Is the Platinum Plan?
The Affordable Care Act, commonly known as ObamaCare, has created four health insurance plans which are named Bronze, Silver, Gold, and Platinum*. All plans must offer the same ObamaCare essential benefits, however individual providers may offer extended/additional benefits. Platinum is the most comprehensive of all theses plans with the highest monthly premium but has the lowest out-of-pocket costs (combination of deductible, copayment, and coinsurance).
*There is also Healthcare Exchange Catastrophic coverage, for those who qualify.
Platinum Plan Basics
The following information below is for individual and family members. Click here to learn about how the Platinum plan works for Small Business owners under ObamaCare.
- 90/10 split, with you paying 10% for healthcare expenses
- Highest monthly premium. This is without federal subsidies, Do I Qualify for Federal Subsidies?
- $0 deductible for medical services for many plans
|Benefits||Platinum Health Plan*|
|Doctor’s Office Visits||$20|
|Brand RX (Tier 2)||$15|
|Maternity||$250 per day HMO**/10% PPO|
|Out-patient Surgery||$250 HMO/10% PPO|
|Hospital Stay||$250 per day HMO**/10% PPO|
|Out-of-Pocket Max||$4,000/$8,000 (ind/fam)|
**Up to 5 days
*This chart is based on California’s Platinum plan. For plans available in your store click here to get an Exchange Quote.
Is there only one Platinum Plan?
Although it is expected that Platinum plans will not have a deductible, there may be multiple Platinum plans offered in the same state. Specific plans will be determined by state leaders and insurance providers.
How does the Platinum Plan Compare to the Other New Plans?
Platinum will cost you the most per month, but will have the least out-of-pocket expenses, therefore you will be able to predict your spending in case of emergency or illness. California currently states that the Platinum plan out of pocket Maximum will be $4000 for individuals and $8000 for families. Something important to note is this plan is likely to attract the highest risk persons, which may in turn raise premiums in the future. Click here to compare Bronze Plan, Silver Plan, Gold Plan, and the Platinum Plan side-by-side.
Health Care Reform and Seniors
Seniors do not have the same options because they will still be enrolled in Medicare. Click here to learn about Medicare and the Health Care Exchange.
For any questions or assistance in applying (open enrollment is from November 15, 2015 to February 15, 2015, please call 800-930-7956 or contact Medicoverage. Click here if you’re ready to apply for a Platinum plan.