The Different Insurance Plans under Obamacare

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The enrollment for the so-called “Obamacare” had started rolling last October 1, a feat won by the administration despite the criticism it has undergone. With such implementation, the plan so far goes smoothly as it is expected to begin its coverage this coming January 1, 2014 and such classes to start in March 31, 2014. With such program, those who haven’t had the chance to buy an insurance plan can get one along with this its subsidized prices.


Politics has indeed shifted the course of where this act is trying to ride. This universal healthcare is a very good idea since most Americans will now have the option to choose their lives against the giant medical bills that will be charged against them. But as with all insurance plans, most of the people are still on the gray matter of it, saying that they’ll indeed try to avail one if they can afford to have one.

With that being said, we have laid down the different coverage that the Affordable Care Act has implemented. As with all healthcare plans, the Obamacare have also produced different policies that will be suited to every individual. There are 4 types of Qualified Health Plans (metal plans) available in the online marketplace. These plans are namely the Gold, Silver, Bronze and Platinum which all differ on the kind of individual that can have the right income to purchase one. But before we lay down the differences of each, let’s talk about what is common within these plans that makes Obamacare an affordable one.

First, all of these plans cover a basic set of benefits such as doctor visits, hospital stays, maternity care, prescription drugs and lab services. With this plans, you can’t be rejected or charged for an extra amount just because you’re already sick -a good change indeed for a health insurance plan.

Now if we take a look at these “metal plans”, they all represent different kinds of metals that somehow also differ in value. Just by saying that, it can be obvious that the bronze coverage is the least expensive one while the platinum coverage is the expensive end. They are categorized based on their actual value – the average percentage of health care expenses that will be paid by the plan. The higher the actuarial value (Gold and Platinum), the more will the plan pay for your health care expenses and therefore, the lower your out-of-pocket costs for things such as:

    • Deductibles – the amount you owe for the covered service before insurance kicks in
    • Co-payments – the fixed amount you pay for a covered health care service
    • Co-insurance – the amount you share of the costs of  covered health care service

This means that every coverage isn’t categorized as to how much you will pay but to how large is the probability of hospitalization that could occur and if you’re capable of such amount when the time comes. So whatever the plan you choose, make sure that it will be the one suited for you.

As such, deciding which plan can be a bit of a challenge. You’ll have to consider the history of your family’s health condition and your financial situation if you’re capable of the out-of-the-pocket expenses. With such, we have laid down the different plans according to how you will need it, not on how much it will cost.

Bronze plan – This plan covers lets the company cover for about 60% of the expenses, which means you are left to shoulder the other 40%, Now, this plan is really not suitable for those who have histories of serious medical conditions because of its limited capability in pying the bill. These are applicable to those who, as we might say, have the “health time” on their side and do not encounter hospital visitations that often.

Silver plan – Compared to the bronze plan, deciding to get this one will entitle you to lower out-of-pocket costs, but certainly higher compared to gold and platinum. It lets the company shoulder the 70% of the cost. Now this plan is a little comparable to the bronze plan. Choose this one if you think you would nee hospital visitations more often than those who chose to purchase the bronze plan.

Gold plan – This is the plan recommended to those who are expecting to have frequent hospital visitations which lets the company shoulder about 80% of the total cost and is by far very beneficial. This is the recommended coverage by the government since this is the expected healthcare usage that average people will tend to purchase in order to get comfortable with their healthcare plan. Together with the platinum plan, both are the coverage required for other insurance companies to participate in the online marketplace.

Platinum plan – This is the plan designed to offer the lowest out-of-pocket expenses for enrollees. It entitles them for about 90% discount to their healthcare costs. Since this plan has the most generous cost-sharing for enrollees, it is also expected that those who will enroll for this will spend a tad higher compared to those who chose the lower-cost plans. This is only practical to those who have serious medical conditions and is expected to have very frequent hospital visitations.

And these are the different coverage of the Obamacare. This act aims to make healthcare affordable and favorable to people who assume the benefits of the plan of their choice.