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Understanding Obamacare: What Are The Major Differences Between Plans On Healthcare.gov?

Nov. 27, 2013
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Question: What are the major differences between plans on healthcare.gov?

Answer: Before the Affordable Care Act, or Obamacare, it was difficult to compare insurance plans. Upfront costs versus quality of coverage, changes in plan designs, exclusions, riders and more made purchasing health insurance a headache. Obamacare has made the process easier by requiring insurance companies that sell plans on the marketplace to categorize plans into Bronze, Silver, Gold and Platinum standards. Healthcare.gov has tools to help you compare plan costs side by side. 

Except for grandfathered plans, new insurance plans must offer certain essential benefits such as preventative care, caps on out-of-pocket spending and deductibles, mental health coverage, and more. A Gold or Platinum plan may have higher a premium but smaller co-pays and deductibles, whereas a Bronze or Silver plan will have lower premiums with higher co-pays and deductibles. So the choice is yours: the plans cover the same services, but if you expect you’ll need more medical attention you may want a plan with lower out-of-pocket costs. 

The type of plan is also important for tax credits or subsidies. Tax credits make sure you can afford a Silver plan no matter the size of your family or your income. But if you’d prefer you can also use the credit on a Bronze or Gold/Platinum plan. For some, a Bronze plan’s cost could be 90% or 100% paid by available tax credits, leaving them to cover only the deductibles and other out-of-pocket costs.

All this means you have greater freedom to compare plans apples to apples. Pick your plan type, decide how you’d prefer to pay, check available tax credits, see which health providers are in the network, and buy your plan. Thanks to Obamacare, comparing plans has never been easier.

—Kevin Kane, lead organizer, Citizen Action of Wisconsin

The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email editor@shepex.com.


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