|Applicant||10/22/1983 Male |
|Insurance Type||ACA (Obamacare)|
|Plan Name||Health Net Platinum 90 CommunityCare HMO|
|Insurance Provider||Health Net|
Costs for Medical Care
|Primary Care Visit to Treat an Injury or Illness||$15 Copay|
|Specialist Visit||$30 Copay|
|Laboratory Outpatient and Professional Services||$15 Copay|
|X-rays and Diagnostic Imaging||$30 Copay|
|Deductible - Family||$0|
|Out-of-Pocket Maximum - Family||$6700|
Prescription drug coverage
|Generic Drugs||$5 Copay|
|Preferred Brand Drugs||$15 Copay|
|Non-Preferred Brand Drugs||$25 Copay|
|Specialty Drugs||10% Coinsurance after deductible|
|Emergency Room Services||$150 Copay|
|Inpatient Hospital Services (e.g., Hospital Stay)||$250 Copay|
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.
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.
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.
The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.