How Health Plans Work

Over and over I hear about how these new metal level plans does not work or pay for anything. This simply is not the case. The reality is most people just don’t have a thorough understanding of how these plans work. Under the new affordable care act law; in general all the plans are based on these three criteria; age, geographical location and ability to pay; in some states tobacco use is taken into consideration, when it comes to your premium dollars.

All level plans Bronze, Silver, Gold, Platinum, and Catastrophic all have the same 10 essential health benefits that must be included with every plan; they just have different deductibles, co-insurances, and co-payment amounts. The way level plans can be explained are: Bronze plans are for people who are healthy and goes to their medical providers once or twice a year, and these individuals should have money to afford higher deductibles.

Silver plans are for people who seek medical attention a little more frequently; three to four times a year; Gold or Platinum level plans are for people who are unhealthy and afflicted with chronic health conditions who need medical attention throughout the year at least once a month or even sooner, and they have the funds available to be able to afford the higher monthly premiums. This is just an overview of what you should consider when choosing a plan.

Catastrophic plans are for individuals under the age of 30 or who has financial hardships at any given moment throughout the year and can clearly show why he or she is unable to afford health insurance. These type of plans has high a deductible; why have such a high deductible in the first place if affordability is a concern? Choose a plan that will meet your individual needs for yourself and your family’s overall health and budget.

Some people think because he or she has a Gold or Platinum level plan they will have better benefits; this is not the case, remember as stated in the second paragraph, each plan just has different deductibles, co-insurances, and co-payments, if you choose to have a higher deductible you take on more risk in the beginning, paying for the majority of your care until you hit that deductible; your premiums will be lower. If you choose to have a lower deductible, your premium will be higher because you are wanting the insurer to start paying out claims much sooner.

My previous articles touched on financial responsibility if you fall through the cracks with too much income to receive assistance; there are ways to mastermind getting through the cracks so this whole new healthcare law can benefit you financially. We suffer as a people because of a lack of knowledge, and not allowing someone else with certain expertise to intervene on our behalf to make things better in situations regarding our health and financial well-being.

Be encouraged and reach out to others who specialize in other areas when you need them; part of your team should include but not limited to: a good business attorney, medical providers when needed, an insurance agent, and an accountant to help you see your way through this new era of healthcare reform.

Always keep in mind; insurance is in place when you need it and not if you need it. Gain a better understanding of this, and perish not