Health Insurance Plans & Levels of Coverage
In order to make it easier to find the plan that’s right for you, health insurance plans are standardized into metal tier categories: gold, silver, bronze and catastrophic.
This sample chart represents the levels of coverage, what plans pay and what enrollees pay, on average:
After Deductible Cost to Consumer
|Gold||More Expensive||80%||20% of Medical Costs|
|Silver||Base||70%||30% of Medical Costs|
|Bronze||Less Expensive||60%||40% of Medical Costs|
|Catastrophic||Least Expensive||<60%||>40% of Medical Costs|
AV (actuarial value) is the average cost paid by the insurance company for your medical bills, such as prescriptions and doctor’s visits. With the bronze plan, for example, the insurance company pays 60% of the cost and the individual pays 40%. The 40% you would be responsible for is made up of deductibles and co-payments based on the type of services received.
- A deductible is the amount of money you’d need to pay out of pocket before certain benefits from the health policy can be used.
- A copayment is the amount of money you have to pay the day of the service to see your doctor or get your prescription.
- To learn more about health plan categories and levels of coverage, please visit this FAQ on the platform.
- To read about what a catastrophic plan is and who can buy one, please visit this FAQ on the platform.