Obamacare Gold Plan

by / Wednesday, 17 April 2013 / Published in Gold Plan, Metal Plans, Uncategorized

There are four tiers, or levels of insurance, provided by the plans that were established in response to the Patient Protection and Affordable Care Act. The four levels are bronze, silver, gold and platinum. The gold plan provides 80 percent coverage which means that someone enrolled in a gold plan would pay 20 percent of their health care costs, while the plan covers the remaining 80 percent. This seems to be a very good mid level plan choice for people who currently have PPO plans that cover 80 percent of the cost. The charge for a gold plan can be no more than 12 percent of income, although high end plans may be subject to a 40 percent excise tax depending on cost. Also, you may pay only a percentage of your total cost depending on your income level.


All plans will cover certain essential health benefits as determined by the U.S. Department of Health and Human Services. These requirements apply to all tiers of health insurance coverage, meaning that differences in the levels of coverage will reflect variation in cost-sharing, not differences in the underlying benefits. All of the plans will all offer the same minimum of benefits which are determined by the federal and state government and must be included in a plan regardless of any additional benefits the plan decides to include. For an insurance company to participate in an exchange, a state run marketplace offering Affordable Care Act plans, the company does not have to offer all four plans but it must offer at least the silver plan and also the gold plan.


Deductibles and coinsurance can vary among gold plans. The out of pocket costs also assume you are using doctors and facilities approve by the plan. If you use a healthcare provider who is not approved, you could pay considerably higher costs and those costs might not apply towards the maximum out of pocket expenses you can pay in a calendar year. The Affordable Care Act provides federal tax credits to people with middle incomes and low incomes whether they are buying individual or family insurance plans. The tax credit is based on the silver plan’s costs. Most individual plans sold next year, even the lowest-level “bronze” plans, are likely to charge higher premiums than today’s most bare-bones individual insurance. For many customers, though, those costs will be offset by lower out-of-pocket costs and more comprehensive coverage


The Patient Protection and Affordable Care Act, commonly called Obamacare or the Affordable Care Act, represents the most significant government expansion and regulatory overhaul of the U.S. healthcare system since 1965. When the federal health insurance mandate goes into effect, most Americans will be required to get health insurance or face a penalty. Market reforms in the Affordable Care Act seek to improve the quality and availability of affordable coverage. The law will require that all plans offered through the exchanges meet a uniform standard of essential health benefits at four levels of cost sharing. The ACA has identified a range of services that must be included in the benefits package and requires preventative services to be covered.

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