Kaiser Health News says California Sets Standard Deductibles & Copays

In our April 02nd post, we wrote about the Patient Protection and Affordable Care Act (PPACA) requirements for bronze, silver, gold and platinum plans. Kaiser recently shared what those terms mean in California.

“Under the rules, the most comprehensive policies classified as gold and platinum level coverage will have no annual deductibles and offer office visits as low as $25. All silver plans, the moderate-price option, will have $2,000 annual deductibles for individuals, charge $45 for primary care office visits and $250 for using emergency rooms. Bronze plans, expected to have the lowest premiums, will have $5,000 deductibles for individuals and $70 office visits. Annual family deductibles are double those of individuals. Consumer cost sharing amounts will be lower for people whose income qualifies them for subsidies.”

“The state does not yet have premium information from insurance carriers, but expects to announce those rates in June,” said Peter Lee, executive director of Covered California, the state’s new insurance exchange. However, “…it does have estimates on how much low-and-moderate income Californians will pay if they qualify for a federal subsidy. Federal law sets that amount based on household income. For a family of four earning $23,550, for example, the monthly payments could be as little as $39 with the federal government picking up the rest of the premium. That same family might see an office visit copayment of as little as $4 because the federal law also includes cost-sharing subsidies for some lower-income Americans.” Further, Lee said, “…he expects residents of every California county will have at least two insurers to choose from.”

Well, as of this writing, that was the clearest explanation we’ve seen of the different tiers and what they could mean for Californians’ pocketbooks.  Have you seen anything clearer?  If so, please do share your resource with us, either in the comments section below or on our Facebook page.

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