What Are Metal Levels?
When Obamacare, otherwise known as the Patient Protection and Affordable Care Act (ACA), became law, it included a tiered system of categories that rate health insurance plans. These levels are broken down into four categories: Bronze, Silver, Gold, and Platinum.
Metal Level Differences
Each metal level differs in how much it costs and how much it covers. The lowest level, Bronze, requires lower premiums but also provides you with less coverage if you do need medical care. Platinum, on the other end of the scale, requires much higher premiums but will cover more of your medical expenses.
What Each Level Covers
The coverage amount is how much the plan will pay, and how much you will pay when you use your coverage. The metal tiers begin at the Bronze level, which covers less of your medical expenses, and ends at the Platinum level which provides you with the highest level of coverage:
Bronze marketplace plans will pay 60% of your medical bill, and you will pay 40% of your medical bill.
Silver marketplace plans will pay 70% of your medical bill, and you will pay 30% of your medical bill.
Gold marketplace plans will pay 80% of your medical bill, and you will pay 20% of your medical bill.
Platinum marketplace plans will pay 90% of your medical bill, and you will pay 10% of your medical bill.
You will still have co-pays with most plans, and these vary from plan to plan even within the same metal level. Your co-insurance and deductibles will also vary per plan. The metal levels also feature a function that helps defray maximum costs per year.
For example, if you have a medical emergency and need to seek out medical attention, you will only have to pay up to your maximum costs for the year. This means if you receive a bill for $28,000, and your maximum cost per year is $3,000, then you will only pay $3,000 while your insurance picks up the rest of the tab for $25,000.
Alternative Options to the Metal Levels
There are three alternatives to these metal levels. You may be exempt if you are grandfathered into a plan. You could additionally choose a plan that is outside the Marketplace. The third option is to forgo health insurance entirely. However, in doing so, you may face penalties on your tax returns and could find yourself facing financial hardships if you end up requiring medical care.
See what options are available to you by giving us a call at 858-771-4087, or enter your zip code here!