At Issue: Health Care 101, Part 2 -- Plan Levels - WCAX.COM Local Vermont News, Weather and Sports-

At Issue: Health Care 101, Part 2 -- Plan Levels

Posted: Updated:

Vermont Health Connect launched its online marketplace Tuesday, where tens of thousands of Vermonters will be required to purchase a plan under the new health care law.

"It makes it easier for Vermonters to compare plans side by side, with apples to apples comparisons," says Vermont Health Access Commissioner Mark Larson. "Which takes some of the guesswork out of being able to purchase a plan that fits best for someone and their budget."

Larson likens it to travel websites, cars.com or Amazon, saying people can put in basic information about themselves and what they're looking for to find available options.

"There will be plans available from both Blue Cross/Blue Shield and MVP, and the kinds of information that people tend to look at in their plans are what are their premiums, are there deductibles, what are the deductibles, what are the co-pays for services that I tend to access -- all of that would be displayed very easily on the website," he says.

There are different levels of plans: Platinum, Gold, Silver, and Bronze. The coverage quality and benefits are the same for all levels but the difference is how much consumers will pay through premiums and how high their co-pays and deductibles will be.

It's all measured by the actuarial value -- or AV -- of the plan -- the percent the insurance company is expected to cover for an average person.

For instance at the Platinum Level, 90 percent of the costs are the responsibility of the insurance company, but in return, your monthly payment for your insurance will be higher. For the next level down, in Gold, 80 percent is covered. Silver is 70 percent, and for Bronze plans, which have the least expensive monthly premiums, the insurance company takes on 60 percent of the costs, meaning you will have to pay more for the services you use.

Which plan is best for you depends on what you're looking for from your coverage.

"If I know that I'm only looking for a Bronze plan, I could ask -- show me the Bronze plans. And it would show me exactly what options are available and what the premiums are, and what the co-pays and deductibles would look like," Larson says.

Navigators can help you in your search, but many people are still waiting to find out if they will have to get insurance on their own, or whether their employer will offer it. Companies with 50 employees or fewer are affected, while larger companies and corporations will continue their existing coverage.

"For small businesses who have struggled to provide very comprehensive plans or contribute very much to those plans -- in some cases, their employees will actually be better off purchasing coverage as an individual with financial help," Larson says.

Vermont Health Connect is hoping those businesses will make their decisions this month so employees can use November to pick their plan. For more information, you can visit their website: healthconnect.vermont.gov.

Powered by WorldNow
All content © Copyright 2000 - 2014 WorldNow and WCAX. All Rights Reserved. For more information on this site, please read our Privacy Policy and Terms of Service.