- Premiums mean the monthly amount you pay in order to keep the insurance from month to month.
- Copayments are made at the time you get care or a prescription.
The premium costs and out-of-pocket copayments change with different plans and plan levels.
Each insurance plan is available at different payment levels, named after metals, Platinum. Gold, Silver and Bronze.
Plans are designed so that the more you pay in monthly premiums, the less you pay in copayments when you see the doctor, get a prescription, or go to the hospital.
The basic health coverage (benefits) at each plan level remain the same -- just the payment differences change.
Plans are named Platinum (90%), Gold (80%), Silver (80%), and Bronze (70%) because the amount you pay in premiums verses copayments change at each level.
In each plan, preventive services will be free of charge. Here is how it works, the more you pay in premiums, the less you pay in copayments. You always must pay the monthly premium, but copayments are only made when you get care. If you add the premium percent and copayment percent together, they will equal 100%. That is how your costs are calculated.
Platinum Plans: For a Platinum plan, 90% of costs are in monthly premium payments and 10% of costs in copayments due at the time you get care. At the Platinum level, premium costs are greatest (90%) and copayments are the lowest (10%).
Gold Plans: The Gold plan will charge 80% of monthly premium costs and 20% in copayments due at the time you get care. At the Gold level, premium costs are lower that the Platinum level (80%) and copayments are higher than the Platinum level (20%).
Silver Plans: For the Silver plan level, 70% of costs are in monthly premium and 30% in copayments. Your maximum financial premium support is at the second lowest Silver plan level. At the Silver level, some of the best values will be available. The Silver level premium and copayment support will make plans at this level a best buy. Your maximum dollar amount of premiums support is at the second lowest Silver plan level.
Bronze Plans: The Bronze plan will charge 60% of costs in the monthly premium and 40% of costs in copayments at the time of service. At the Bronze level, premium support is limited to the cost of a Bronze plan and will not be more than the second lowest Silver level assistance. At the Bronze level, copayments will be higher than the Silver level. Bronze level may not be your best choice because the premium support is no more than the second lowest Silver level amount and copayment assistance of 40% is more than the Silver level at 30%. This reason is why the Bronze level is not the best choice if your guidelines income level is between 100% and 400% (1 to 4 times guidelines).
PLAN TYPE WITH PREMIUM AND COPAYMENT PERCENTAGE
CLICK HERE to see rates for the Second Lowest Silver Plan in the 48 States and D.C. Hawaii and Alaska Marketplaces will have higher income levels.
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