When you're in need of a healthcare policy for you and your family, your options can seem endless. Between balancing your monthly premium rate with your anticipated out-of-pocket costs, it's important to make sure that you can find coverage without going over budget.
At HealthMarkets Insurance Agency, we are dedicated to all of your health insurance needs. When you're looking for healthcare coverage, any of our licensed, knowledgeable agents can help your find the right policy for your family's needs.
What to Consider in a Healthcare Plan
While finding a plan that fits your budget can be important, it's equally important to find a plan that provides the coverage your family needs to maintain good health.
With the passing of the Affordable Care Act (ACA) in 2010, millions of Americans were able to access affordable health care with the coverage level that fit their health requirements. Here are some important consideration to keep in mind while you determine the right policy.
Know Your Metal Levels
When you begin your search for a health insurance policy, you may learn about different levels of coverage, or "metal levels" that determine how much your health insurance provider will cover versus how much you'll have to pay in monthly premiums.
Based on the type of plan, your health insurance will cover some percentage of your healthcare costs, leaving you paying the rest. There are generally four metal levels to choose from:
- Bronze: 60% covered by your insurance, 40% covered by you.
- Silver: 70% covered by your insurance, 30% covered by you.
- Gold: 80% covered by your insurance, 20% covered by you.
- Platinum: 90% covered by your insurance, 10% covered by you.
Learn About Essential Health Benefits
No matter which plan you choose, your health plan is required to covered ten essential health benefits, as required by the ACA. This mandatory list of covered services ensures that all Americans with health insurance have access to basic health care, regardless of how much they pay for health insurance.
- Prescription drugs
- Pediatric services
- Preventive and wellness services
- Emergency services
- Mental health and addiction services
- Pregnancy, maternity, and newborn care
- Ambulatory patient services
- Laboratory services
- Rehabilitative and habilitative services and devices
Get Help Paying for Health Care with Subsidies
Yet another benefit under the ACA is the subsidy program that allows low-income families to afford health insurance plans. This program typically helps families making anywhere between 100% and 250% of the Federal Poverty Line; and can even help families making up to 400%.
- Premium Tax Credit: This subsidy helps reduce the cost of your monthly premiums by getting federal assistance to either pay some or all of your premium directly to your health insurance provider. You can also receive this credit by filing a tax return.
- Cost-Sharing Reduction: This subsidy helps cover your out-of-pocket costs when you receive health care. This can include your deductible, copay, or coinsurance.
Find Your Healthcare Policy with HealthMarkets
HealthMarkets Insurance Agency works with more than 180 insurance providers nationwide. Our licensed agents can help you find great options chosen just for you so that you can pick the one that's right for you.