Chapter 9How to Choose Your Coverage—Bronze, Silver, Gold, or Platinum

In the past, choosing the right individual health insurance coverage was complicated—it was nearly impossible to make side-by-side comparisons due to so many variations among different insurance plans. But, that is no longer the case. The Affordable Care Act has standardized the coverage provided by plans in the individual market. All individual health insurance plans must now be categorized into one of four standard levels of coverage: Bronze, Silver, Gold, or Platinum. (A fifth category, referred to as catastrophic coverage, may also be available in your state. Catastrophic plans pay less than 60 percent of the total average cost of care on average and are available only to people who are under 30 years old or have a hardship exemption.) Additionally, new benefit coverage requirements and out-of-pocket limits now apply to all individual health insurance plans. These standardizations have made it easy to compare and contrast the coverage provided by different individual health insurance plans and insurance companies.

When narrowing your choices to specific plans, you should evaluate the following coverage components for each option: (1) plan category, (2) out-of-pocket exposure, and (3) covered benefits.

Choosing a Plan Category

The plan category you choose affects the average amount of money you will be required to spend on out-of-pocket costs in a year. Regardless of where you live, all plans in the individual ...

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