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Understanding what you’re looking for in a health insurance plan may save you money when selecting health insurance. Specific benefits and health service coverage can influence which plan you choose. Access to information on how different health insurance plans work may help individuals choose a plan for their unique set of healthcare needs.

In general, most people look for two things in a health insurance plan: coverage for necessary medical needs and affordable costs.

Know Your Benefits

The Affordable Care Act requires that providers cover 10 essential health benefits regardless of what you pay for your health insurance:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health services and addiction treatment, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services, and chronic disease treatment
  10. Pediatric services, including oral and vision

Check Your Service Coverage

With your essential benefits covered, it’s important to know the amount you pay for your healthcare services. Each health plan category is designed to cover a certain percentage of the average population’s medical costs:

  • Bronze: Plan is designed to pay 60%, plan participants would pay around 40%.
  • Silver: Plan is designed to pay 70%, plan participants would pay around 30%.
  • Gold: Plan is designed to pay 80%, plan participants would pay around 20%.
  • Platinum: Plan is designed to pay 90%, plan participants would pay around 10%.

Depending on the plan category, or metal level, your selection determines how much you pay in monthly premiums. In general, the higher the metal level, the higher your monthly premium rate.

Between comparing costs and coverage, looking for a health insurance plan might require extra assistance. HealthMarkets Insurance Agency has dedicated agents to help you find what you want in a health insurance plan. We can compare plans for you to find the best one for your needs.

Give us a call at (800) 360-1402, get a free quote online, or meet with one of our local, licensed agents today.

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Sources:

HHS: http://www.hhs.gov/healthcare/rights/
Forbes: http://www.forbes.com/sites/investopedia/2013/10/11/essential-health-benefits-under-the-affordable-care-act/

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