There will be four different levels of plan coverage. Platinum plans will pay 90 percent of covered expenses, on average; gold plans will pay 80 percent; silver plans 70 percent; and bronze plans 60 percent.
Tax credits to help cover the cost of the premiums for plans sold on the exchanges will be available to people with incomes up to 400 percent of the federal poverty level (about $46,000 for an individual; $94,000 for a family of four ), and cost-sharing subsidies will reduce out-of-pocket costs for people with incomes up to 250 percent of poverty ($28,725 for an individual).
The maximum amount that consumers will owe out of pocket for in-network medical claims will generally be capped at about $6,400 for individuals and $12,700 for families in 2014. (Note that those figures don't include money spent on premiums.)
How all those variables come together can have a big effect on people with high medical expenses.
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For example, even though the premium for a platinum plan will generally be higher, the out-of-pocket spending cap may be significantly lower than other coverage levels since platinum plans must cover 90 percent of expenses. In California, for example, the out-of-pocket spending limit on a platinum plan is $4,000, compared with $6,400 for other plans.
For people who expect to hit their spending cap, buying a pricier platinum plan may actually result in lower total spending, says Marc Boutin, executive vice president and chief operating officer at the National Health Council, a patient advocacy organization.
"It's counterintuitive," he says.
Insurers anticipate that people with high medical costs will gravitate toward platinum and, to a lesser extent, gold plans, and they're pricing those plans accordingly, say experts.
If only one member of a family has high medical expenses, families may want to consider splitting coverage between different plans.
"Many insurers are expecting that savvy families will enroll a sick family member in a platinum plan and the rest in lower level plans," says Jennifer Tolbert, director of state health reform with the Kaiser Family Foundation.