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. Other Metal Plans include Bronze, Silver, and Gold. Also, a Catastrophic Plan is available to young adults and to some people with hardship exemptions.Platinum plans have the highest premiums and the lowest cost-sharing. They only make sense for those who know they will use medical services that will result in net savings due to greater cost-sharing.
Platinum Plans Have the Highest Premiums
Platinum plans are designed to cover 90% of out-of-pocket costs on average. This is known as having an Actuarial Value of 90%. This means for a standard population the plan will on average cover 90% of all out-of-pocket costs for essential health benefits. This is not the exact amount of cost-sharing your plan will provide you.
Given the generous cost-sharing, platinum plans have the highest premiums on average. Not all insurers offer Platinum plans on the Marketplace. Different states may have different rules for what these plans must offer beyond minimum standards in the ACA.
Platinum Plans and Subsidies
You can use Tax Credits to lower your premium on Platinium Plans. However, you won’t get as much assistance as you will on other Metal Plan types.
Should I get a Platinum Plan?
If you know your family will use a lot of medical services, and you don’t qualify for Cost Sharing Reduction subsidies, Platinum plans can end up providing the best value. When you compare plans, you’ll want to look at projected medical spending and compare that to your premium.
Also, be aware that in the future it is possible that high-end plans will be subject to an excise tax (this was repealed, but always come back into play some day, so it is good to keep an eye on). In health insurance it’s common to over-buy. So don’t buy a platinum plan because you want the best, buy a platinum plan because it fits your health care needs.
All Plans Provide Minimum Coverage
All plans must provide minimum benefits, minimum protections, and minimum value. No matter what plan you choose you’ll get a free wellness visit, free preventive care, and won’t be out more than your maximum in an emergency. Platinum plans will typically offer more than the minimum in terms of benefits and will often offer even better than the minimum cost-sharing amounts to attract customers. That being said, at the end of the day both the most expensive plan and the cheapest will cover the essentials.
Do I Have to Use the Marketplace?
If you want cost assistance, you have to get a Marketplace plan. However, a qualified health insurance agent, broker, or provider can help you shop for Marketplace plans they offer.