Reply #43: Policies have to meet minimum standards to be on exchange [View All]

[jbnow]

and they are well laid out as to what must be covered.
There are also a number of things that they can't even charge a copay for, mostly preventative tests/care, including well baby care
Mental health coverage is included in all policies.

As far as high copay part there is an annual cap on how much a patient can be made to pay out of pocket even if they are in the hospital for a long time. It tops out at just under 5,000 (10K for a family) for those above subsidy level but it is lower as income goes down so the top lower income people could be made to pay in a year is $2,000

The other things that keeps this out of junk status are the other protections involved like no annual or lifetime cap on coverage. And remember they have to spend at least 80/85% of premiums collected on patient care. (It is under 50% in some areas now)

Policies on exchange will be competing for customers so the odds are they'll set their copay/deductible in a pretty sane fashion

However I think repay is punishing. If your income goes up you will now be paying higher premiums and I bet you have a lot of repair and replacement in your home and life.

With all the job lay offs it made me wonder what safety nets there are for someone who suddenly has huge drop in income. They can't wait a year for help with premiums