2024 Health Plan Benefit Summary and Member Cost-Sharing
2023 Standard Benefit Design Metal Tier Health Plan Summary
2022 Standard Benefit Design Health Plan Summary
2020 Metal Tier Health Plan Benefit Summary
Health care services subject to the deductible of Bronze and Silver Plans
- Facility fee for in-patient hospitalization
- Physician or surgeon fees for in-patient hospitalization
- Out-patient surgery costs
- Skilled nursing
- Durable medical equipment
- Some high cost imaging services
- Always refer to your Evidence of Coverage for additional services that may be subject to the deductible.
Several of the carriers also offer off-exchange plans (plans not sold through Covered California). Some of these plans have slightly different benefit designs than the Covered California standard benefit design and are usually less expensive, but they don’t qualify for the subsidies. Carriers offering off-exchange plans are Aetna, Anthem Blue Cross, Blue Shield, Bright Health Plan, Chinese Community Health Plan, Health Net, Kaiser, Oscar, and Western Health Advantage. Sutter Health Plus offers standard benefit design plans only off-exchange in the Bay Area and Sacramento region.
All carriers in Covered California also offer a mirrored version of the Silver 70 health plan at lower rates than are charged through Covered California.