Affordable Care Act
What Is a Gold Health Plan?
Published on January 29, 2019
Under Obamacare, which is also known as the Affordable Care Act (ACA) each health insurance plan is assigned a certain metal level. This means that there are bronze, silver, platinum, and gold health plans. Each type of metal level has a certain set of benefits, costs, and services. Additionally, the health plans for each metal level also include a certain actuarial value (AV). For example, a gold health plan has an AV level of 80 percent, which means that the insurance provider will pay 80 percent of the covered medical expenses up to the plan’s designated out of pocket maximum. For anyone interested in choosing a gold health insurance plan, it is important that the other metal levels are also considered.
Understanding the difference between a gold health plan and the other metal levels.
In order to choose the health plan that is right for you (and your family) it is important that you first understand the differences between the gold health plan and the other metal levels. It is important to note that each insurance provider will offer slight variations on their gold health plans, which means that the following information should be viewed as a general guide. Be sure to carefully read each plan’s offering, before you select a gold health insurance plan.
- Bronze. — The bronze health plan typically has the lowest monthly premium. It also typically has the highest costs when medical care is needed, and often has a very high deductible that can reach thousands of dollars on an annual basis. Bronze health plans are typically good for individuals who need protection from the worst-case medical scenarios, such as serious illnesses or injuries.
- Silver. — The silver health plan typically has moderate monthly premiums. It also has moderate monthly costs when medical care is needed, and typically features a lower deductible than bronze plans. Silver health plans are often a good choice for individuals who anticipate only needing moderate medical care throughout the year.
- Gold. — A gold health plan typically has higher monthly premiums than silver or bronze plans. It also has lower monthly costs when medical care is needed, and typically features a lower deductible than the silver or bronze health plans. The gold health plan is often a good choice if for an individual who anticipates needing medical care on a regular basis throughout the year.
- Platinum. — A platinum health plan typically has higher monthly premiums than a bronze, silver, or gold health insurance plan. It also features the lowest costs when medical care is needed, and typically has the lowest deductible out of all of the plans. The platinum health plan is often a good choice for individuals who can pay high monthly premiums and expect to need a lot of medical care throughout the year.
What are the other costs associated with a gold health plan?
Whether you want to choose a gold or a different metal level, it is important that you think about the total health costs. This means that you need to consider more than your monthly premium when you choose your insurance plan. For example, you should consider out of pocket expenses, as well as the list of following potential costs.
- Copayments. — The payments that you need to make each time you receive a medical service after you have reached your deductible are referred to as copayments.
- Deductible. — The deductible is the amount of money that you will need to spend on covered medical services before your insurance provider will begin to cover the costs. Preventive services are often the exception to the later rule, whereby these services will often be paid for in your gold health plan.
- Out of pocket maximum. — This payment refers to the most amount of money that you will spend in covered medical services for an entire year. Once you have reached your deductible your insurance provider will often pay for 100 percent of covered medical expenses.
How can you decide if a gold health plan is right for you?
Once you have compared the features of metal levels and reviewed the costs, you can decide if a gold health insurance plan is right for you. To answer this question, you will need to review your anticipated medical needs for the upcoming year, and eHealth makes this easier by offering quotes on health insurance plans for free. For example, if you expect to have a lot of doctor visits, and anticipate needing regular prescriptions throughout the year, then the gold health plan will probably be the right choice. In conclusion, it is important that you take your time reviewing all of the available health insurance plans before deciding if the gold health insurance plan is right for you.