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What Is the Bronze Plan?

The Affordable Care Act, otherwise known as Obamacare, requires insurance companies in 2014 to offer new categories of health insurance plans to consumers: Bronze, Silver, Gold, and Platinum. These plans will all offer a minimum standard of benefits determined by the government. This minimum standard is known as the plan’s "essential health benefits."

Generally speaking, the Bronze Plan is intended to have the lowest premium of the 4 new categories of plans but charge the highest out-of-pocket costs for healthcare services. For people without group insurance from an employer or other group, the Bronze plan is the minimum health insurance plan in which they can enroll that will satisfy the Affordable Care Act’s mandate for people to purchase health insurance.

How are Bronze Plans different than other Obamacare health plans?

The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Bronze Plan pays 60% of typical medical costs while the other Obamacare health plans pay a higher percentage of these costs.

How much does a Bronze Plan cost?

The monthly premium for a Bronze Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. Starting October 1, 2013, you can use HealthPocket’s to compare Bronze Plan premiums in your area.
When Can I Enroll in a Bronze Plan?

In the first Open Enrollment period for the new Affordable Care Act health plans begins in October 1, 2013. The coverage for plans enrolled in during 2013 will begin January 1, 2014. See our Open Enrollment article for more information.

How much will a doctor visit cost for a Bronze Plan?

It depends on the Bronze Plan in which you enroll as well as your state of residence. For example, in California Bronze Plans have a standardized charge of $60 (or 40% of total cost for HSA Bronze plans) for a primary care visit. In other states, the doctor visit charge is not standardized. HealthPocket’s research on preliminary Bronze Plan rate filings found that doctor visit copayment charge averaged $41 across the states that were analyzed.

One of the issues to consider is that a deductible may apply to a doctor visit, which means you would pay the full cost until you satisfy the deductible amount on the plan. In California, the first three non-preventive care visits are exempted from a deductible but subsequent doctor visits are not exempted. The full cost of a doctor visit can be well over $100 depending on a person’s region.

How much will I have to pay for prescription drugs on a Bronze Plan?

All qualified health plans will be required to include prescription drug coverage starting in 2014. However, that does not mean that your specific medications will be covered. The Affordable Care Act requires that at least one drug is covered in each therapeutic category and class. However, an individual state’s choice of a benchmark plan will provide the exact number of drugs that are required within each category and class. Depending on the health plan, this can mean that the cholesterol lowering drug Zocor may be covered but Lipitor is not covered. Before enrolling in a Bronze plan (or any health plan), it is important to determine:

Are your medications covered?
What are the copayment or coinsurance fees for your medications?
Are there any restrictions placed on your medications (e.g. the need for prior authorization)?

Another consideration regarding drug costs is a deductible amount may need to be satisfied before the plan begins to share the cost of drugs.

What Is the Deductible Amount for a Bronze Plan?

A deductible is the amount a consumer pays for covered medical services. The final answer to that question won’t be determined until all the health plans are made public in October 2013 but an examination of early rate filings found Bronze Plan medical deductibles were on $4,509 average.
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