Helping You Protect Your Money. Helping You Protect Your Future.
When looking for health insurance on the government exchanges, you will immediately be struck by the labeling of health plans by "metal" categories.
This organizational scheme is both important to understand in itself and also because it is indicative of a fundamental way to fit any health insurance option to your particular needs - even if it's an off-exchange option without an official metal assigned to it.
How Does The Metal System Work?
While there are new options and changes in health insurance coverage coming for 2019 and beyond, the metal system appears to be here to stay. This approach labels each health plan as bronze, silver, gold, or platinum to correspond to the cost sharing set up. Metals do NOT indicate quality of care or health network considerations or anything other than the cost sharing arrangement.
The system is based on how you and your insurance carrier cost share (split) the cost of your medical expenses. The metal level has nothing to do with the quality of the health care provided to you.
Here is how the system works:
If you get government subsidies for health insurance, then your real costs will be lower based on income level. But, of course, if you go beyond your subsidy amount to get a higher metal plan, you'll still have to pay premiums every month, even if highly discounted.
How To "Find Your Metal"
Estimating what your household’s use of care for the plan year is the first step in determining what level meets your own family’s health needs as well as financial ability. You might need to hash things out with an experienced health insurance agent to figure out which metal is right for you. It can take a little research into the amount and nature of your likely healthcare expenses combined with running scenarios for each metal level.
But, here is a basic guide to when you might want to choose each metal: