According to study by the Kaiser Family Foundation analyzing ACA Benchmark premiums in the largest cities from 15 states and the District of Columbia, there will be a mixture of premium increases and premium decreases for the benchmark Silver plans in 2015. While many of the Silver plans sold on the Exchanges in 2014 will charge higher premiums in 2015, the new plans being sold on these Exchanges will have prices below (in some cases well below) the prices for the returning plans.
Details are now available on the costs associated with health plans being offered through Healthcare.gov, and some people are finding their insurance will cost more than they had hoped. Until last week, the federal government blocked users from viewing deductible amounts associated with available health plans, limiting consumers to view only premium and copayment amounts. Insurers assumed consumers would pick plans mainly on price, as reflected in the monthly premium, so it was to their advantage, as well as to the government’s, that consumers were unable to view a plan’s annual deductible, or the amount consumers need to pay before coverage kicks in. The federal government finally relented and allowed consumers to basically ‘window shop’ for coverage. For policies offered in the federal exchange, the annual deductible often tops $5,000 for an individual and $10,000 for a couple. The average individual deductible for what is called a bronze plan on the exchange is $5,081 a year, according to a new report on insurance offerings in 34 of the 36 states that are relying on the federally run marketplace. While the costs of these plans are surprising many, they are more generous than what is currently available in the individual market. However, the plans are significantly less generous than what most employers are providing, creating a sticker shock sensation to consumers that are no longer receiving employer-sponsored health insurance.
Catastrophic plans offer limited physician’s visits, and higher copays, deductibles, and lower monthly payments. Only individuals under the age of 30, or that qualify for the “hardship exemption” are eligible the purchase a catastrophic health plan.
Bronze plans will have coinsurance levels of 60%.
Silver plans will have coinsurance levels of 70%.
Gold plans will have coinsurance levels of 80%.
Platinum plans will have coinsurance levels of 90%.
ambulatory patient services
emergency services hospitalization
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)
