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What Is the Difference Between the Metal Plans?
PLATINUM | GOLD | SILVER | BRONZE
From 1/1/2014 on, all individual and family health insurance plans will have these “Metallic” names whether you purchase health insurance “On Exchange” or “Off Exchange”. It gives you an easy-to-understand overview of how the plans will share the payment of your medical bills.
Health insurance companies that sell plans on the Health Insurance Marketplace can offer four types of qualified health insurance plans, including Bronze, Silver, Gold, and Platinum. The plan you choose determines not only the premium you pay but also what portion of your health costs you pay.
To make it easier to shop for coverage, health insurance plans have standardized “metals”. The “metal” plan depends on its actuarial value, or the average percentage of health care costs the plan pays vs what the member pays. The more coverage a plan provides, the higher the monthly premium and the fancier the metal level. Gold is better than Silver. Silver is better than Bronze.
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Platinum plans cover 90% of medical expenses
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Gold plans cover 80% of medical expenses
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Silver plans cover 70% of medical expenses
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Bronze plans cover 60% of medical expenses
This percentage will not go on forever, there is always an “Out of Pocket Maximum” (this is your pocket, not the insurance company), so you’ll only pay your portion of the expenses until you’ve reached your out-of-pocket maximum.
The Out-of-Pocket Maximums for 2023 are:
Individuals: $9,100 Families: $17,400
You’ll want to review your “Summary of Benefits and Coverage” to find out what your deductible is, your co-insurance, your out-of-pocket maximum, along with all of the important details of what your plan covers.
What Do the Health Insurance Plans Cover?
Regardless of the plan you choose, it will provide all 10 essential health care benefits guaranteed to policyholders under the Affordable Care Act. The difference among the plans has to do with how much overall out-of-pocket costs you’ll pay up to your out-of-pocket maximum.
Choose the Right Health Plan with Nevada Insurance Enrollment
Choosing the right metal tier requires evaluating your budget and assessing current and expected health care needs. Our agents guide you in reviewing the options available across the tiers and help you determine which plan best fits your health needs and budget. We can also help you determine whether you qualify for subsidies to lower your premium.
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What is Co-Insurance?
Co-insurance means two parties will be paying for the bill. “Co” means joint, mutual, two, or more. The health insurance company will usually pay the larger amount (example 70%) and you as the member will usually pay the lesser amount (example 30%). This would be considered co-insurance 70/30. This (co-insurance) usually happens AFTER the deductible is met.
Is Health Insurance Worth The Cost?
If you experience a more extensive medical emergency and require hospitalization, hospital bills may quickly become a burden. A three-day stay, for example, could set you back about $60,000 depending on what tests are ordered and what happens during your stay.
Surrogacy Laws in Nevada
Generally speaking, the intended parents are responsible for covering pregnancy-related expenses, including complications that may arise over the course of the pregnancy and delivery. The standard way to control health care costs is to purchase health insurance for the woman acting as the gestational surrogate.
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