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Health Insurance Basics

Tips for Choosing Between the 4 Levels of Affordable Care Act Plans

October 16, 2017

ACA Health Insurance Basics

During the Open Enrollment period each year, you can shop for an individual insurance plan. If you decide to purchase a plan, it will begin January 1 of the next year.

Before you choose a plan, carefully consider your life situation and think about your needs. Are you single or do you have a family? Are you employed or unemployed? Do you have a major illness? Answers to these questions can help determine the kind of plan you need. In fact, your monthly ACA premium will be based mainly on:

  • The plan type you choose
  • Your age
  • Your location
  • Smoker or non-smoker
  • Number of enrollees, such as your child or spouse
  • The insurance company you choose

Plans are priced at four different levels of benefits: Bronze, the most basic plan, Silver, Gold, and Platinum at the top end. Not all plan levels are available in all markets — check availability at HealthCare.gov. What you pay for insurance may also depend on your income — for more information on premiums and subsidies, go to HealthCare.gov.

Understand the Four ACA Health Insurance Plans

Here's what to expect from the four plan levels:

  • Bronze: Expect low monthly premiums, covered check-ups and preventive care. If you're younger and have no children, or if you also don't see a doctor very often, this plan could be right for you. Your out-of-pocket costs may be higher.
  • Silver: Monthly premiums remain low, but out-of-pocket costs for a hospital or specialist visit are lower than Bronze. Preventive care costs you nothing, because you have no copay or deductible. If you're in good health, Silver may be the right fit.
  • Gold: You can anticipate moderate monthly premiums, but your out-of-pocket expenses will be lower if you get sick or need to go to the hospital. You'll also have a lower deductible so that means you pay less when you visit the doctor.
  • Platinum: Only offered in California, monthly premiums cost more. Emergencies are covered as are regular doctor visits and preventive care. You have no deductible, or it's very low. Coverage is comprehensive, and you save on out-of-pocket costs.