Many of the health insurance regulations in the ACA have made it easier to compare apples to apples in the individual health insurance market. There are no more “junk” plans with low benefit maximums or major holes in the coverage. All policies cover maternity (although that has been the case in Colorado since 2011). Preventive care is covered before the deductible with no copays or coinsurance. All policies must cover the essential health benefits with no annual or lifetime maximums (there can still be limits on the number of visits for some treatments). And all policies must have out-of-pocket maximums of no more than $6350 ($12,700 family) in 2014.
Other than Catastrophic plans, which are available for people under 30 and those who have a hardship exemption from the exchange, which includes people who had a 2013 policy that was terminated in December, all policies available in Connect for Health Colorado (and off-exchange too) fall into one of four categories: bronze, silver, gold or platinum (virtually all of them are bronze, silver or gold though). Also, Catastrophic plans aren’t significantly less expensive in Colorado. The designation is based on the actuarial value of each policy. Bronze plans cover roughly 60% of costs; silver, 70%; gold, 80%; and platinum, 90%. After the maximum out-of-pocket is met, all policies cover 100% of covered costs (with some rare exceptions, such as policies that put an annual limit on the number of covered visits for services like home healthcare and skilled nursing).
But comparing apples to apples still takes quite a bit of reading. Within each metal level, there’s a wide variety of different plans available from the many different carriers offering policies in the exchange (Anthem Blue Cross Blue Shield, Cigna, Colorado HealthOP, Elevate by Denver Health, Humana, Kaiser Permanente, Rocky Mountain Health Plans, United Health). Networks vary considerably, but so do the plan designs