Benefits & Coverage
Costs for Medical Care
Prescription drug coverage
Access to doctors and hospitals
Medical Management Programs
Child Dental Coverage
Adult Dental Coverage
Exclusions and Limitations
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Routine Foot Care
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Abortion for Which Public Funding is Prohibited
Laboratory Outpatient and Professional Services
Rehabilitative Speech Therapy
Well Baby Visits and Care
Bone Marrow Transplants for Treatment of Breast Cancer
Congenital Anomaly, including Cleft Lip/Palate
Early Intervention Services
Hormone Replacement Therapy (HRT)
Human Leukocyte Antigen Testing
Hypodermic Syringes or Needles
Off Label Prescription Drugs
Fitness Club Reimbursement
Low Protein Foods
Minor Dental Care - Child
Convenience Health Care Clinics
Weight Loss Programs
Outpatient Rehabilitation Services
Dental Check-Up for Children
Inpatient Rehabilitation Services
Rehabilitative Occupational and Rehabilitative Physical Therapy
Treatment for Temporomandibular Joint Disorders
Long-Term/Custodial Nursing Home Care
What To Know
- This is an ACA (Obamacare) compliant health plan.
Enter your ZIP Code to see physicians that accepts Focus Network MA- Affordable HMO 25 plan in your area.
Enter your ZIP Code to see Similar Plans to Focus Network MA- Affordable HMO 25 plan in your area.
Types of Health Insurance
Health Insurance in 2018
Platinum plan frequently asked questions (FAQ)
What is the Platinum Plan?
ObamaCare’s Platinum Plan is a type of Metal Plan on the Health Insurance Marketplace. Platinum Plans qualify for Tax Credits and have the highest premiums. A Platinum Plan is designed to incur the lowest out-of-pocket expenses for enrollees. A typical platinum plan enrollee pays approximately 10% of the costs of covered healthcare services with the plan paying the remainder. In comparison, a typical Bronze Plan enrollee pays 40% of covered medical expenses.
How are Platinum Plans different than other Obamacare health plans?
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Platinum Plan pays 90% of covered medical costs for a typical enrollee while the other Obamacare health plans pay a lower percentage of these costs.
How much does a Platinum Plan cost?
The monthly premium for a Platinum Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Platinum Plan premiums in your area.
When Can I Enroll in a Platinum Plan?
The Open Enrollment period for Affordable Care Act health plans begins November 1, 2015 and continues through January 31, 2016. See our Open Enrollment article for more information.