What Color is Your Health Insurance Plan?

Oct 4, 2013

All this week, we’ve been taking a look at one of the key provisions of the Affordable Care Act—health insurance exchanges—as they began rolling out around the country October 1st.

Credit Virginia Alvino / WBOI News

Today, we explore the basics on the types of plans offered in the marketplace.

Consumers buying coverage from Indiana’s federally-run health insurance exchange will have to ask themselves a question: how much do they expect to spend on healthcare this year?

The answer to that question Insurance plans offered through the exchanges fall into four main categories: bronze, silver, gold and platinum.  

Indiana University Purdue University Fort Wayne professor and medical ethicist Abe Schwab says, starting with the bronze plan, each policy covers more of a consumer’s healthcare costs, but with increasingly higher premiums.

“If the average healthcare consumer in your age bracket with your characteristics would use $8,000 in healthcare expenditures a year…then that means the bronze plan would cover 60 percent of that, or $4,800 of the $8,000. And then you would end up covering $3,200 of the $8,000.”

As you’d expect, premiums get more expensive as you choose higher-level plans, but they also cover progressively more of your costs, up to 90 percent.

There is one other policy available to consumers that’s not listed among the regular metal policies: a catastrophic plan.

If a consumer is young, uninsured, and can prove that purchasing a bronze plan would be prohibitively expensive, providers can offer these plans to cover worst-case scenarios. The premiums are lower, but policy holders are only covered only if they need a lot of care.