Since the Affordable Care Act changed the way most people compare and purchase health insurance. Since the rollout of Affordable Care Act (ObamaCare) in 2013, health insurance is now primarily purchased through state and federal exchanges like Healthcare.gov.
Health insurance plans sold “on exchange” are offered in four coverage levels: Bronze, Silver, Gold, and Platinum. Metal categories are based on how you and your plan split the costs of your health care. They have nothing to do with quality of care.
A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more.
All plans offered in the Marketplace cover these 10 essential health benefits:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
Some plans cover additional services.
Generally, plans in the Bronze category have the lowest premiums (your monthly insurance bill) but the highest deductibles and other out-of-pocket costs. Platinum plans generally have the highest premiums but the lowest deductibles and other out-of-pocket costs.
We offer referral services for enrollment assistance for individuals and families seeking to purchase health insurance through Health Insurance Marketplace (ObamaCare).