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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.
This also applies to damage that occurs after the accident. While you may consider the damage from the accident and the damage from the tow truck to be all one incident, your insurer will view it differently.
If your friend was hit by an insured driver, the process will be simple enough. The at-fault driver will file a claim with their insurance company, who will pay to get your vehicle back to pre-accident condition. If the collision was bad enough to cause an injury, the at-fault driver’s auto insurance could also cover medical bills, lost wages and any other expenses associated with the accident.
Generally speaking, anyone who lives with you that has a drivers license – whether they’re a member of your family or not – is considered by your insurer to be a member of your household. College students away from home without a vehicle aren’t required to be on a policy, and could be a “permissive” driver.
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A high-risk driver is one who is more likely to file a claim. To determine your riskiness, your auto insurance company uses a complex algorithm that weighs in a variety of factors to come up with your auto insurance score.
Telemedicine puts healthcare within reach of those who would otherwise have a difficult time visiting a doctor. If you have a severe sinus infection, the last thing you want to do is spend the afternoon in the doctor’s office.
Do you have car damage that needs to be repaired or parts that need to be replaced? You may assume that the repairs will be done using OEM parts, which means “Original Equipment Manufacturer”, but this isn’t always the case so make sure to review the coverages you have in your auto insurance policy.
Gap insurance is optional auto insurance coverage that covers the difference between the actual cash value (ACV) and the amount owed on the loan of your car if your car is totaled or stolen. Standard auto insurance covers the current depreciated value of your car.