Butler County residents have 38 health plans to choose from on the new Health Insurance Marketplace.

The marketplace, which was established by the Affordable Care Act, opened Oct. 1.

Of the plans available, 18 are from UPMC, 15 are from Highmark and five are from HealthAmericaOne.

Roseanne Placey, press secretary for the state Department of Insurance, said insurance companies applied to the U.S. Department of Health and Human Services to have plans for the marketplace, and then the state Department of Insurance reviewed the plans and rates. Finally, HHS gave approval.

Placey noted that the old private insurance market still exists.

“This gives folks another option,” Placey said.

She said that state officials had worked for two years to try to get a state-based exchange, but they did not get a definitive answer from HHS as to what exactly they would need to do. So, they chose to use the federal exchange.

Plans available in the marketplace are required to cover 10 essential health benefits: ambulatory patient services, emergency service, hospitalization, maternity and newborn care, mental health services, prescription drugs, rehabilitative services, laboratory services, preventive and wellness services, and pediatric services.

However, plans can cover a variety of services.

Five different categories for the plans exist. Most plans are categorized as bronze, silver, gold and platinum. Bronze plans have a low premium, but require that patients pay a larger amount for their care, while platinum plans have high premiums and low care costs.

Bronze plan patients pay 40 percent of their costs, silver plan patients pay 30 percent, gold plan patients pay 20 percent and platinum plan patients pay 10 percent.

Butler County has eight bronze plans, 13 silver plans, 12 gold plans and one platinum plan.

There also is a catastrophic category, which is designed for people under age 30 with low incomes. These plans require patients to pay for all medical costs up to a set amount, which usually is a few thousand dollars. Essential health care over that amount is covered by the insurance company.

These plans also cover three primary care visits per year and some preventive procedures at no cost. Four catastrophic plans are offered in the county.

In the county, the least expensive plan offered is a catastrophic plan from Highmark with a monthly premium of $103 for a 27-year-old individual and $350 for a family of four.

The most expensive plan offered is a gold plan from UPMC with a monthly premium of $320 for a 27-year-old and $1,083 for a family.

Kristin Ash, a spokeswoman for Highmark, said that the plans the company has in the marketplace also are available out of the marketplace for the same prices.

However, she noted that people who meet certain income requirements and who buy through the insurance exchange can get government subsidies to help pay for their plan.

Outside the marketplace, Highmark is able to determine rates based on a number of issues such as pre-existing health conditions. But for plans in the marketplace, they charge rates primarily on age.

“That's pretty much the only thing we can rate on, Ash said.

She said that the company has had an increased number of calls about the marketplace, but it has not been swamped.

“We anticipated that we would have more calls,” Ash said.

Coverage begins Jan. 1.

People can apply for insurance from the exchange by visiting www.healthcare.gov or calling 800-318-2596.