It’s important to research your options and know what plans are available to you.
To help, we’ve outlined the health insurance plans available through Healthcare.gov. For starters, plans on the government exchange are offered at four levels and are referred to as “metal plans” because they are all designated by precious metals. Then there is a separate type of plan called a catastrophic plan that consumers can consider as well.
So, what’s the difference between the metal tiers?
The bronze plan is an economy plan. It has the lowest monthly premium, but the highest out-of-pocket costs. It is set up to have the insurance companies cover 60 percent of your healthcare costs, which leaves 40 percent to come out of your pocket. Because the out-of-pocket costs for this plan are high, it’s ideal for someone with good health who doesn’t plan on going to the doctor’s office often.
Bronze Plans Starting from $1/Day
With this plan, 70 percent of out-of-pocket costs are covered by the insurance company, while the consumer covers the remaining 30 percent. The silver plan may be enticing to low-income individuals as you can only qualify for out-of-pocket savings (known as the cost-sharing reduction) by choosing a silver plan. You can, however, qualify for premium tax credits with any metal plan.
Silver Plans Starting from $3.33/Day
The gold plan has insurance companies covering 80 percent of medical care costs, which leaves 20 percent to be paid by the consumer. In exchange for the lower out-of-pocket costs, consumers will have to pay a higher premium. This plan is great for people who require frequent care and as a result, prefer lower out-of-pocket costs.
Gold Plans Starting from $4.99/Day
The final plan of the “metal plan” family is the platinum plan. This plan has the highest monthly premium, but the lowest out-of-pocket costs. In fact, the consumer is responsible for only 10 percent of their medical costs, while the insurance company pays for 90 percent. As such, this plan is great for consumers with conditions that require constant care or prescriptions.
Platinum Plans Starting from $6.67/Day
A catastrophic plan is available to people who are 30 or younger, or someone who qualifies for a hardship exemption. With catastrophic plans, the consumer gets lower premiums and is covered for catastrophic medical events. But each catastrophic plan has a very high annual deductible (generally several thousand dollars per year) that must be met before the insurance kicks in.
Some of the more common hardship exemptions are:
These government plans allow you to find coverage that fits your lifestyle and budget. Regardless of whether you decide to buy coverage from the government marketplace or the private exchange, just be sure to get covered before the open enrollment deadline.