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
Weight Loss Programs
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Outpatient Rehabilitation Services
Routine Foot Care
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Laboratory Outpatient and Professional Services
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Congenital Anomaly, including Cleft Lip/Palate
Off Label Prescription Drugs
Port-Wine Stain Removal
Prescription Drugs Other
Residential Treatment for Children with Emotional Disabilities
Services to Ventilator-Dependent Persons
Treatment of Lyme Disease
Diethylstilbestrol Exposure Treatment
Routine Patient Cost for Clinical Trials
Testing for STD's
Treatment for STD's
Treatment for Lyme Disease
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Dental Check-Up for Children
Long-Term/Custodial Nursing Home Care
Abortion for Which Public Funding is Prohibited
What To Know
- This is an ACA (Obamacare) compliant health plan.
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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 the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.