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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.
The majority of health insurance companies have a contract with a network of hospitals and other providers. In this contract, there are negotiated rates for different services. This negotiated rate is generally lower and sometimes significantly lower than what a provider would charge someone who is paying out of pocket.
To help customers avoid buyer’s remorse, health insurance policies are required to offer a free-look period. If at any time during this period you find that you’re dissatisfied with your policy, you can cancel it and get your money back.
In most cases, when someone is talking about state-based health insurance, they’re referring to a health insurance plan that is regulated by the Department of Insurance in that state. These plans are sold through state health insurance exchanges.
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Car seats are designed to accommodate your household’s youngest passengers, making sure that they are as safe as possible while on the road. However, did you know that just like helmets and other safety equipment, car seats have a shelf life?
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Even if it’s been determined that you definitely are not responsible for the accident, you can file a claim under your own comprehensive coverage and pay your deductible. Then, because it’s the financial responsibility of the at-fault driver and their insurer to get you back to pre-accident condition, your insurance company would use subrogation to file a claim with the other insurance company. This will allow them to get back any money paid out for repairs, including your deductible.
Nevada Health Coop will NO LONGER be offering insurance after 2015. They will continue to be operational throughout 2015, so if you happen to have Nevada Health CO-OP as your insurance company, your claims will still be paid. You can still go to doctors, however, you’ll need to select a new plan for 2016