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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.
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.
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.
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.
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.
Your health insurance premium amount isn’t random. A variety of factors affect how much you’ll pay every month for your coverage. Under the ACA, there are only a handful of things that can affect your health insurance premium.
Getting married means lots of conversations about combining everything from last names to bank accounts. While picking a health insurance plan that covers both of you may seem practical, there are cases in which maintaining separate policies makes more sense.
If you are among the 55 percent of Americans that are taking a prescription drug, you may be concerned about the affordability of medication therapy. Fortunately, there are a couple of things that you can do to ease the financial burden.
By page visits (this month)
By page visits (this month)
In most cases, dental insurance pays for routine care such as annual x-rays, cleanings and exams, as well as procedures such as fillings, crowns and bridges. Health insurance pays for damage caused by a trauma to the mouth, such as an injury or accident.
What happens if you need healthcare services when you are hundreds of miles away from the nearest in-network provider? How you receive emergency or non-emergency medical care and pay for it depends largely on your health insurance plan.
If you have a qualified health plan (QHP) the answer is yes, ambulance rides are covered. A QHP is an insurance plan that is certified by Nevada Health Link in Nevada that covers “10 essential health care benefits” including emergency transportation. You may need to pay a deductible, co-payment, or co-insurance for your ambulance trip.
You have an auto insurance policy that covers damage to your vehicle, but what if you regularly use your vehicle to pull your trailer? Does that trailer have the same coverage as your car or truck?