Knowing some basic information before choosing a health insurance plan can make the process easier.
The 4 "metal" categories: There are 4 categories of health insurance plans: Bronze, Silver, Gold, and Platinum. The lower the metal, the less you pay in monthly premiums. However, you pay more when you need to use healthcare services. For example: you may pay 40% of costs on a Bronze plan, while your insurance company pays 60%. But, on a Platinum plan you may only have to pay 10%, while your insurance company pays 90%.
Your total costs for health care: You pay a monthly bill to your insurance company (a "premium"), even if you don't use medical services that month. You may pay out-of-pocket costs, including a deductible, co-payment, co-insurance or an out-of-pocket maximum when you get care. It's important to think about these costs when choosing a plan.
- Plan and network types: HMO, PPO, POS, and EPO. Some plan types allow you to use almost any doctor or health care facility. Others limit your choices or charge you more if you use providers outside their network. Learn more about plan and network types.
If you qualify for cost-sharing reductions you must pick a Silver plan to get the extra savings. You can save hundreds or even thousands of dollars per year if you use a lot of care.
Note: Plans in all categories provide free preventive care, and some offer selected free or discounted services before you meet your deductible.
In order to pick a plan based on your total costs of care, you'll need to estimate the medical services you'll use for the year ahead.
- When you view plans, you'll see an estimate of your total costs - including monthly premiums and all out-of-pocket costs.