There’s nothing we want more than to protect our family from the worst case scenario. When we buy family medical insurance, we want to make sure we have the coverage we need so that we are prepared for anything. Between finding the right plan category and premiums, you be assured that your family is secured.
By shopping and comparing health insurance plans, you can find the right plan for your family’s needs. You should understand how premiums can affect your out-of-pocket costs for treatment and services, as well as your essential benefits.
Your Essential Benefits
No matter which medical insurance plan you enroll in, you are guaranteed to have coverage for ten essential health benefits, regardless of how much you pay in premiums. These benefits include:
- Ambulatory patient services
- Emergency services
- Hospitalization, including surgery
- Maternity and newborn care
- Mental health services and addiction treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services, and chronic disease treatment
- Pediatric services, including oral and vision
Health Plan Categories
While essential health benefits are standard in every health plan, the cost you pay in premiums versus the amount you have to pay out of pocket for every hospital and doctor service you receive varies. The type of plan category you purchase can affect these costs, but it has no effect on the amount or quality of care you receive.
There are four categories or “metal levels” of coverage:
- Bronze: Your plan covers about 60%, you pay about 40%.
- Silver: Your plan covers about 70%, you pay about 30%.
- Gold: Your plan covers about 80%, you pay about 20%.
- Platinum: Your plan covers about 90%, you pay about 10%.
Choosing the right plan category for your family takes into account the amount of medical attention you expect to receive. If you don’t anticipate using medical services regularly and don’t take prescription medicine, a Bronze or Silver plan would better suit your budget. If you do plan on using your insurance frequently, a Gold or Platinum plan would save you money on out-of-pocket expenses.
If you need help determining the amount of coverage you’ll need, HealthMarkets Insurance Agency is here to help.
When you work with our licensed representatives, you’ll receive the care and dedication you should expect from an insurance representative when you look for a family medical insurance plan. Charlie from LaCygne, KS said, “My relationship with my agent has been a positive and long lasting business relationship. I know my agent has my best interest at heart and I trust her advice and expertise.”
Let’s see how we can help you. Contact a representative today.