It may feel like you have endless options when finding the right government affordable health insurance. With so many to choose from, it’s primarily important to understand your own medical needs and anticipate the amount of health care coverage you’ll need can help you determine the amount you’ll need and how much to pay in monthly premiums.
No two health insurance plans are alike because people have unique health requirements. The type of plan you get and the amount you pay in premiums can help you save money regardless of the medical services and treatment you require.
Understand Your Essentials
Thanks to the Affordable Care Act, no matter what type of health insurance plan you purchase, there are ten essential health benefits you are required to receive regardless of how much you pay in monthly premiums. They include coverage for:
- Ambulatory patient services (outpatient care)
- Emergency services
- Hospitalizations, including surgeries and transplants
- 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 dental and vision
Whether you purchased an advanced or standard plan (or anything in between), you are required to receive coverage for these medical services for your general well-being.
Categories of Coverage
Depending on how often you will need to use your health insurance during your year of coverage can help determine the amount you will need to pay per month versus out of pocket. Enrolling in the right health insurance plan category can help you save money no matter how many times you anticipate using your plan.
There are four plan categories, or “metal levels” to choose from:
- Bronze: Your plan covers 60%, you pay 40%.
- Silver: Your plan covers 70%, you pay 30%.
- Gold: Your plan covers 80%, you pay 20%.
- Platinum: Your plan covers 90%, you pay 10%.
If you anticipate needing a lot of coverage (i.e., for prescription drugs or medical treatment), you should consider a higher tier category, such as Gold or Platinum. However, if you are looking for coverage solely for emergency or annual services, a lower tier category, such as Bronze or Silver, may help you save money in the long run.
Determining how much coverage you’ll need for an entire year can be difficult. Our licensed representatives at HealthMarkets Insurance Agency can help. We can help guide you and find the best options for your unique medical or anticipated needs.