The federal government also allows Silver health insurance policyholders to receive cost-sharing reductions if their household income falls below 250% of the federal poverty level - for example, earning less than $69,375 per year for a family of four. These plans are best suited for individuals or families with average health insurance needs and household income. Silver metal tier plans are middle-ground policies with modest premiums and deductibles. Keep in mind that Catastrophic plans are not eligible for premium tax credits. For this reason, Bronze and Catastrophic plans are best for individuals who are in great health and do not expect to have large medical expenses during the year. Choosing the right health insurance plan will require you to identify which plan tier is best for your current health and financial situation.Ĭatastrophic and Bronze health plans have the cheapest monthly costs, but you'll pay a larger portion of your medical expenses because plans have high deductibles and out-of-pocket maximums. In most state health insurance exchanges, there are five coverage levels available for purchase: Catastrophic, Bronze, Silver, Gold and Platinum. When comparing health insurance plans, tiers can help you understand how the cost of a plan relates to the level of medical benefits you get.
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How to compare metal tiers of health insurance You should try to predict your medical expenses for the next year and choose a plan that will provide you with the most benefits possible combined with a deductible that you could afford to reach. Since you are responsible for all expenses before the deductible, if you choose a deductible that is too high and you have a large medical expense, you may not be able to cover the cost of treatment. However, the monthly bills you pay for the insurance plan are not included.īoth the out-of-pocket maximum and deductible are essential to consider when evaluating the affordability of policies. This means what you spend toward your deductible as well as copayments and coinsurance will count toward reaching your out-of-pocket maximum. Remember that the calculations are based on medical spending. The out-of-pocket maximum protects you from very high costs if you need expensive or ongoing medical care. After your medical spending reaches this amount, the insurance company pays for 100% of the cost of covered health services.
The out-of-pocket maximum is the limit on how much you could spend on medical care in a year.
Some services, such as preventive care, are excluded from a plan's deductible, but typically, your medical care is more expensive at the beginning of the policy year before your spending reaches the deductible.
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For example, you could pay the full cost of an X-ray before you reach the deductible. The deductible is the amount of medical care you must pay for in full before your plan's benefits kick in and allow you to pay a portion of your medical costs called the coinsurance or copayment. When comparing health insurance plans, evaluate the premiums and calculate, based on your income, which policies are affordable financially. Premiums for marketplace plans are a monthly payment that you will be billed for by the health insurer that you choose. The premium is the price of health insurance and what you will pay to continue to be covered. This involves looking at the different coverage levels, also called tiers (Catastrophic, Bronze, Silver, Gold and Platinum), and comparing each provider network (PPO, EPO, HMO and POS). When looking for the right health insurance plan, you must understand and compare each of these policy components and then choose a policy that provides health coverage at an affordable cost.
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