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What will the marketplace health plans look like?

@patriciaborns  We probably won't know what the new Affordable Care Act marketplace health plans offer until Oct. 1. Reportedly, even insurance agents who've been certified to sell marketplace plans haven't seen them yet.

But Kaiser Health News has some clues: "The number of plans that consumers will have to choose from is likely to vary widely. In some states, only a couple of insurers have announced plans to offer policies though the marketplace, while in others there may be a dozen or more."

Florida has 11 providers offering marketplace health plans.

Even within a state, there will be differences in the number of plans available in different areas, says Kaiser. This is because of the availability of provider networks. Miamians, for example, are likely to have more choices than someone in a less populated area. You can expect that insurers will offer a variety of types of plans, including familiar models like PPOs and HMOs.

There will be some important differences, however, reports Kaiser. "All of the plans sold on the exchanges will offer a similar package of 10 essential health benefits that provide comprehensive coverage. How much consumers will owe in cost sharing will vary depending on which of four types of plan they choose." 

Reportedly, plans will be sold off of the marketplace as well that comply with the Affordable Care Act. People who already have a health plan should be receiving letters from their insurers, if they haven't already, offering them an opportunity to stay on the plan if the company has "grandfathered" it (filed it with the state's insurance commissioner). 

In a platinum plan, the most generous plan offered, the insurer will pay 90 percent of covered medical expenses and the consumer will be responsible for 10 percent, on average. In a gold plan, the insurer will pay 80 percent and the consumer 20 percent. Silver plans will pay 70 percent and bronze plans 60 percent.

There will also be a high deductible catastrophic plan that's available to people up to age 30, reports Kaiser. It will cover only limited benefits before the deductible is met.


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