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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.
Most people have never heard of association health plans; however, these health insurance plans have been around for decades. Association Health Plans may have fewer benefits but will most likely have lower premiums, making them an attractive option for those who are young, healthy, and on a budget.
According to a recent study, health insurance premiums could increase for individual plans on the ACA marketplace between 35 and 94 percent by 2021. Concern over health care is nothing new; in fact, this is the fifth consecutive year that Americans have ranked health care as a top concern.
At least for now, many aspects of ACA are still in place. Currently, an insurer can’t turn you away for a pre-existing condition, and long-term health insurance plans still have to provide coverage for ACA’s 10 essential health care benefits. Prior to 2010, private health insurance usually did not cover maternity, or preventative like it does now, and mental health was generally non-existent.
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We HIGHLY recommend you double check that your physician will take the Nevada Health COOP plan you are enrolling into.
Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts during their first 18 months with health insurance
Anyone who can show that their individual or family policy has been cancelled, will be eligible to buy a “catastrophic” plan through the Nevada Health Link.
Changes to the way medical billing works will be coming on Oct. 1, 2014. The health care medical billing system will change over to a new computerized system.