When you compare Marketplace insurance plans, they’re put into 5 categories based on how you and the plan can expect to share the costs of care:
All Marketplace insurance plan categories offer the same set of essential health benefits. The categories do not reflect the quality or amount of care the plans provide.
The category you choose affects how much your premium costs each month and what portion of the bill you pay for things like hospital visits or prescription medications. It also affects your total out-of-pocket costs —the total amount you’ll spend for the year if you need lots of care.
The maximum out-of-pocket costs for any Marketplace plan for 2014 are $6,350 for an individual plan and $12,700 for a family plan.
Note: Catastrophic plans – which have very high deductibles and essentially provide protection from worst-case scenarios, like a serious accident or extended illness — are available to people under 30 years old and to people who have hardship exemptions from the fee that most people without health coverage must pay. Learn more about catastrophic plans.
As with all health plans, you’ll have to pay a monthly premium. But it’s also important to know how much you have to pay out-of-pocket for services when you get care.
Think about the health care needs of your household when considering which Marketplace insurance plan to buy.
Do you expect a lot of doctor visits or need regular prescriptions?
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