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Platinum plan

What is a Platinum plan?

All ACA-compliant individual and small-group health plans sold in the exchange or outside the exchange must fall into one of four metal level ranges. (See Obamacare metal plans.)

Platinum plans have an actuarial value range of 86-92%. Actuarial value refers to the percentage of total medical costs that a health plan will pay across a standard population. But for any particular enrollee, the percentage of costs that a plan pays will depend on the extent of care that a person needs, and whether or not they meet their out-of-pocket limit for the year.

The ACA’s premium subsidies can be applied to Platinum plans if there are any Platinum plans available. But in many states, Platinum plans are not available in the individual market.

During the open enrollment period for 2022 coverage, Platinum plans for individual/family coverage were only available through the exchange in 16 states. Total enrollment in Platinum plans through the exchanges only amounted to 136,486 people (out of more than 14.5 million total enrollees nationwide).



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