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How are health plans organized at my state's marketplace?

ANSWER

Health plans in states are organized:

The type of plan can affect how much choice you have in health care professionals, which medications are covered, and your out-of-pocket costs.

  • First by metal level: Bronze, silver, gold, or platinum
  • Second by price
  • Third by type of health plan, such as HMO, PPO, POS, or high-deductible plans with a health savings account

SOURCES:

Health Insurance 101: "What is a health insurance exchange?" and "What does it mean to standardize health insurance plans, and how does it help consumers?"

Kaiser Family Foundation: "Private Insurance Benefits and Cost-Sharing Under the ACA."

Center for Consumer Information and Insurance Oversight (CCIO): "Essential Health Benefits Standards: Ensuring Quality, Affordable Coverage;" "Essential Benefits Bulletin;" "Explaining Health Care Reform: Questions About Health Insurance Exchanges."

HealthCare.gov.

U.S. Department of Health and Human Services.

HealthConnector: "Health Insurance for Massachusetts Residents."

Kaiser Health News: "A Guide to Health Insurance Exchanges."

Center for Consumer Information and Insurance Oversight (CCIO).

Reviewed by Sarah Goodell on September 16, 2019

SOURCES:

Health Insurance 101: "What is a health insurance exchange?" and "What does it mean to standardize health insurance plans, and how does it help consumers?"

Kaiser Family Foundation: "Private Insurance Benefits and Cost-Sharing Under the ACA."

Center for Consumer Information and Insurance Oversight (CCIO): "Essential Health Benefits Standards: Ensuring Quality, Affordable Coverage;" "Essential Benefits Bulletin;" "Explaining Health Care Reform: Questions About Health Insurance Exchanges."

HealthCare.gov.

U.S. Department of Health and Human Services.

HealthConnector: "Health Insurance for Massachusetts Residents."

Kaiser Health News: "A Guide to Health Insurance Exchanges."

Center for Consumer Information and Insurance Oversight (CCIO).

Reviewed by Sarah Goodell on September 16, 2019

NEXT QUESTION:

What are the services covered by all options at my state's marketplace?

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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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