Affordable Care Act: Where Things Stand Now

, New York Law Journal

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Sidney Kess
Sidney Kess

Individuals obtain insurance through:

• Large groups (employer plans);

• Small groups (plans of small businesses);

• Individual market (through government exchanges or directly from insurers);

• Public programs (Medicare, Medicaid, Tricare, CHIPs).

Individual policies must meet certain coverage requirements (e.g., provide certain preventive care; have no limits for pre-existing conditions). There are five types of acceptable policies:

• Bronze—these plans limit out-of-pocket costs to 60 percent of the limits under Health Savings Accounts (HSAs);

• Silver—these plans limit out-of-pocket costs to 70 percent of the limits under HSAs;

• Gold—these plans limit out-of-pocket costs to 80 percent of the limits under HSAs;

• Platinum—these plans limit out-of-pocket costs to 90 percent of the limits under HSAs;

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