Metal Plans: Bronze, Silver, Gold, and Platinum 2


Ever wonder why insurance policies are labeled bronze, silver, gold, or platinum and what these different plans mean?

Wonder no more. Jeff Hess, individual, group, and ancillary health expert, explains these metal plans in the video below. Watch now!

Metal Plans

We have metal plans: bronze, silver, gold, platinum, and of course you have your catastrophic. Now you hear these, but what do they actually mean? The bronze plan is the lowest level of coverage; that is what they call an actuarial value of 60%. The silver is a 70% actuarial value of coverage. Gold is 80% actuarial value, and the platinum is a 90% actuarial value. What does all that mean? Basically, what this means is that the bronze plan typically takes into account – on the spectrum of everybody – the average cost that the policyholder would spend on their health coverage minus their premium. With the bronze plan, the insurance company is going to pay 60% of everything, of the expense, and 40% would be from the policyholder. As for the silver plan, which is a 70% actuarial value plan, the insurance company covers 70% of the average cost for everyone out there with a silver plan so that the policyholder would only be responsible for 30% up until they meet their out-of-pocket maximums and so on and so forth when it comes to the higher plans.

Catastrophic Plan

Now the catastrophic plan is probably the cheapest plan out there. However, it has a lot of strings, even more so than the others. Typically, in order to get a catastrophic plan you have to be 30 or younger or have experienced some sort of hardship. The list of hardships are on healthcare.gov, or you can talk to your agent, who should have a list as well. It’s a very long and extensive list – and quite eclectic – including issues like paying your utility bills and having your power shut off, which would exempt you from having to have one of the metal plans and would qualify you for a catastrophic plan.

Conclusion

So you’ll hear a lot of the insurance talk about bronze, silver, etc… it’s just a way to identify good, better, best, awesome. Ultimately, they use the precious metals to scale the plans accordingly. The bronze is the most out-of-pocket compared to a platinum plan; that’s what that means.


Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  So if you have any questions or concerns, comment below and your question may be the topic of our next video!


Leave a Reply to empowerhealth Cancel reply

Your email address will not be published. Required fields are marked *

2 thoughts on “Metal Plans: Bronze, Silver, Gold, and Platinum

  • Michele Mayers

    Are there ANY PLANS that are just easy to understand, cover the needs of the individuals , and ,basically, non mind boggling , And straight to the darn point? Example….. My fiancee, works everyday, as a roofer, and is starting to have COPD,and asthma like symptoms. Ok, no,problem. I’ve had to take him to emergency room a few times. Get prescription,etc.. ARE THERE ANY PLANS THAT WORK HERE? I don’t care if it’s 300 to 400 $$ a month, BUT, IF HE NEEDS CARE OR HOSPITALIZATION, THEN SO BE IT. IS THAT TOO MUCH TO ADK FOR?

    • empowerhealth

      Michele, yes there are plans that are relatively easy to understand. You do have time to decide or change coverage, so I would recommend having our agents shop for you and explain it all to you in layman’s terms. The ACA plans are simple enough, if explained by someone who has studied them. Your Fiancé may need to get an accident plan, coupled with a marketplace plan to cover preexisting conditions. Short-term medical won’t cover preexisting, nor would most hospital plans. But an accident plan would cover him if he has an accident on the job and the marketplace plans would cover his treatment regardless of whether he has it before coverage begins. Call our agents and let them see what’s best and have them explain it to you. Even if you chose something already, have them shop and give you their advice. We care about our clients and hope you have a happy marriage and a Merry Christmas. Call us at (844) 410-1320 to get in touch with one of our agents. I’m sure we can give you some options.