Covered California is California’s insurance exchange starting in 2014. Some basic differences between the plans are highlighted in their chart as per the Blue Shield email received saying “…the California Exchange website released information on benefits, resources, etc. preparing for 2014….”

Last month, the Los Angeles Times published an article from the “Times’ Opinion Staff” reviewing a “chart (comes) from the Covered California insurance exchange, one of the new state marketplaces for individual insurance policies created by the Patient Protection and Affordable Care Act (a.k.a. Obamacare). As required by the Affordable Care Act, it will make four basic types of policies available: Bronze, Silver, Gold and Platinum. Insurers who want to offer a different flavor of coverage in the exchange could do so only with Covered California’s permission.”

“All four of the basic policy tiers will cover at least the essential benefits mandated by Obamacare…that means the policies must cover at least as much as Kaiser’s HMO plan for small businesses does. Where they will differ is in the amount of out-of-pocket costs. The Platinum tier has the lowest deductibles and copays, so its premiums should be higher than the plans in the other tiers. The Bronze plan, by contrast, has a high deductible, so its premiums should be significantly lower.”

“Congress wanted to accomplish at least two things with the standardized insurance plans. One was to make sure insurers didn’t sell policies that ignored costly risks and left customers underinsured. Another was to make it considerably easier for consumers to compare plans when shopping for insurance.”

“The new chart by Covered California shows how much simpler the process will be. There will be no variation in out-of-pocket costs among policies within each tier; for example, all individual Bronze plans will have a $5,000 deductible and a $120 copay for urgent care after the deductible is reached, and all Gold plans will have no deductible and a $90 copay for urgent care. The main differences within the tier will be the monthly premiums and, potentially, coverage for some less common types of care, such as infertility treatments or prosthetics.”

“The federal government will provide tax subsidies to anyone earning less than four times the federal poverty level. Those subsidies effectively limit premiums to a percentage of a person’s income; according to Covered California’s chart, premiums for a Silver plan would range from $19 a month for a single person near the poverty line to $1,255 for an adult with seven dependents who just barely qualifies for subsidies.”

In addition to the chart, you might find the Cost Estimate Calculator helpful.

 

 

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