Types of Individual Health Plans

Types of individual health plans

Although they must cover certain benefits, health plans still vary in how they are structured and how much of your health care costs they pay.
Health plans are divided into five categories to make comparing them easier. The categories are based on the percentage of health care costs the plans pay and the portion you pay out of pocket, including the deductible, copayments and coinsurance. The percentages are estimates based on the amount of medical care an average person would use in a year. The categories are:

  • Bronze – Pays 60 percent of your health care costs. You pay 40 percent.
  • Silver – Pays 70 percent of your health care costs. You pay 30 percent.
  • Gold – Pays 80 percent of your health care costs. You pay 20 percent.
  • Platinum – Pays 90 percent of your health care costs. You pay 10 percent.

Generally, the less you pay out-of-pocket for the deductible, co-payments and co-insurance, the more you pay in premiums for the coverage. So, in this case, Platinum plans will charge higher premiums than the other three plans, but you won’t pay as much if you need healthcare services. Bronze, meanwhile, has the lowest premiums, but the highest out-of-pocket costs.
So, when deciding on the level, think about the healthcare services you used over the past year and what you expect for next year. For instance, if you plan on starting a family, take into account how much out-of-pocket costs you’ll have to pay if you go with a Bronze plan.
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