What Do Health Insurance Metal Levels Mean?
A health insurance plan pays a certain part of your healthcare costs. The question is how far a health insurance plan will be this generous. How much of your healthcare expenses will be covered by your plan and how much would you have to shell out from your pockets? To be aware of that, you first need to understand the concept of metal tiers of each health plan. There are four tiers in all – platinum, gold, silver, and bronze. The platinum plans are considered to be the most generous ones, followed by gold, silver, and bronze. This was a basic explanation. To know more, go through the details outlined below.
What Do The Experts Say About Metal Tiers?
According to the experts, platinum plans are the most generous as they are supposed to offer the maximum coverage for your healthcare costs. In case you choose a platinum plan, 90% of the healthcare expenses will be covered by the health insurance provider. Aside from that, these plans are also known for the highest premium. Next, come the gold plans. When you choose a gold plan, you can be assured of the fact that 80% of your healthcare costs will be covered.
The premiums associated with gold plans are the second highest. Any plan in the silver tier will be covering 70% of the healthcare expenditures. Silver premium is the third highest. As far as the bronze tier is concerned, plans will pay for 60% of your healthcare expenses. The premiums in this tier are the lowest. Below the bronze tier, lies the catastrophic coverage. They pay you less than 60% of your healthcare costs and are offered to individuals who are either aged below 30 or are going through tough situations.
How Would You Know Which Metal Tier Would Suit You?
First, you need to find out if you are eligible for government subsidies. If you are eligible for financial help, you can choose a silver plan. The reason is you can utilize the cost-sharing reductions to pay for copays as well as coinsurance when you have selected a silver-tier plan. In case you are not sure if you have the eligibility to avail of cost-sharing reductions to afford health insurance, carry out an estimation of your eligibility. You will get help online or from a broker.
Lower Premiums Imply Less Generous Tier Plans
If having to pay lower premiums allure you, then you are not the only one. After all who would want to miss the opportunity of paying the lowest amount possible every month to have your healthcare costs covered. However, you are missing out on one very basic point. Plans that require you to pay lower premiums will also have higher deductibles which will be tougher for you to shell out.
This means you have to incur expenses from your pocket even before your insurance plan gets active. Plans with higher premiums have lower deductibles. If this is rephrased in simple words, you might aim to save now, but eventually, you will have to pay more in the later stages.
The Percentages Might Not Be As You Expect
By now you know how much value you are going to get from each tier plan. However, you must know the fact that the actual value can be lower than you expect (sometimes, higher). This happens because the percentages are dependent on the actuarial value. Actuarial value is actually an average of covered costs.
For the actuarial value, a health insurance provider brings the people who choose a particular tier plan, together and then adds their healthcare expenses. For instance, a platinum tie plan will cover 90% of the total healthcare costs for the entire group. Anyone from the group might get less or more value from the tiered plan.
Importance Of A Customized Recommendation
GPS or GetInsured Plan Scores need to be checked out if you want to get aware of the plans in your area. This will make choosing a tiered plan must more convenient. You can contact a broker to know your GPS scores., which depends on how you avail yourself of healthcare throughout the year.
Now that you have some basic information about health insurance metal levels, choose what suits you best. All you need at the end of the day is a proper health insurance plan that covers most of your needs.
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