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.

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Health Insurance 'Metal Plans' Explained

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.

  • Platinum plans cover 90% of medical expenses

  • Gold plans cover 80% of medical expenses

  • Silver plans cover 70% of medical expenses

  • 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.​

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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.

Health Insurance: What is a Single Payer System?

Health Insurance: What is a Single Payer System?

A single-payer health care system is one in which there is one party that collects all healthcare fees and covers all health care costs. In theory, this could reduce medical costs because there would be significantly fewer entities involved in the system, thus cutting down on administrative costs.

What Is A State Based Health Insurance Exchange?

What Is A State Based Health Insurance Exchange?

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.

Health Insurance Options For Laid-Off Workers

Health Insurance Options For Laid-Off Workers

If you rely on employer-based health insurance and you lose your job, you may wonder what happens if you need medical care before you are able to get new coverage. Fortunately, there is COBRA, a law passed in 1986 gives many workers and their families the right to retain their health insurance even if they quit or lose their jobs.

 

By page visits (this month)

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog

#5) Request a Quote

By page visits (this month)

 

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog Posts

#5) Request a Quote

Filing An Appeal To A Health Insurance Company

If your health insurance company refuses to cover a claim, you have the right to appeal the decision and have it reviewed by a third party. Your policy should outline how to appeal a denial.

What Does Guaranteed Issue Health Insurance Mean?

Guaranteed issue means that the health insurance coverage is guaranteed to be issued to applicants, regardless of their medical history, their age, their gender, or any other factors that might increase their likelihood of using health services.

Get The Most From Your Health Insurance Plan

Today’s Health Insurance plans may offer benefits above and beyond just doctors and hospitals, such as free preventive services, fitness programs, teledoc/telehealth, and so much more!

Health Care Sharing Ministry; Is It Right for Me?

Although once considered a fringe option for those unable to or uninterested in purchasing traditional health insurance, Christian ministry programs have experienced a surge in popularity in recent years, adding millions of subscribers.