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Health Insurance Metals Explained

Oct 05, 2021
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As we move from the summer to the winter Olympics, it seems only fitting to talk about bronze, silver, and gold. Like the Olympic metals, types of health insurance plans are categorized into metal levels. Unlike Olympic metal categories, health insurance metals have nothing to do with quality or performance. Rather, health insurance metals help people understand the amount of cost-sharing that goes on between the plan holder and the insurance company in any given plan. (Need a refresher on what cost sharing means? Check out our health insurance lingo blog post here!) 

Remember that the exact amount of cost-sharing can vary from plan to plan. According to healthcare.gov, at each metal level, you’ll pay a different percentage of total yearly costs of your care, and your insurance company will pay the rest. Total costs include premiums, deductibles, and out-of-pocket costs like co-payments and co-insurance.

As a rule, the less the insurance company pays in cost-sharing, the lower the cost of the plan. So, Bronze plans typically have the lowest monthly premium costs and highest costs when you need care. Monthly premium costs generally increase according to metal levels. Silver, Gold, and Platinum cost more each month in premium payments but will have lowers costs when you need care. While your monthly premium price is often the top consideration when purchasing health insurance, it’s important to consider the deductible and cost-sharing as well, since these two factors can impact the total amount of out-of-pocket healthcare costs you might incur in a plan year. The total cost of care is what really matters.

When choosing a plan, you’ll want to think about how much you (and your dependents) are likely to use your insurance coverage. Consider things like how often you see a doctor, what medications you take, and whether you foresee scheduling any elective surgery during the year to come. If you think you’ll use your healthcare plan frequently or have prescription medications you take regularly, you might want to consider a higher metal level that offers lower deductibles and makes your costs easier to predict (like a Gold or Platinum plan). If you don’t expect needing many healthcare services, a lower-premium/higher cost-share plan might be a better fit.

One thing that’s important to know is that ALL Health Options’ plans in ALL metal categories offer $0 cost-share preventive care, including yearly wellness checks. Many plans also offer an array of low-to-no-cost benefits that help offset many healthcare expenses (like wellness visits, prescription benefits, and vaccines), even for people with chronic conditions. All non-HSA plans offer Amwell® urgent care telehealth visits with $0 cost-sharing. So, whether you go for the Gold, qualify for Silver, or choose any of the other plan options, having healthcare insurance is extremely valuable in adding to your quality of life and peace of mind.

SEE ALSO

Even in the best of times, Maine winters are better for eating comfort food and hibernating than for starting a new routine of physical fitness and better eating. But the pandemic makes physical and mental wellbeing even more important than ever, and Health Options has some valuable tools for helping you put one foot in front of the other on the road to wellness.

We all know the benefits of eating well when it comes to mental strength, stamina, and weight loss, but there are also many links between diet and stress. According to Healthwise, you can make a few simple changes, like not overdoing caffeine and alcohol and avoiding eating on the run, so that your daily habits support stress defense. Read more diet tips here.

Or watch this video for more easy tips, like remembering to eat breakfast and planning meals in advance.

Likewise, even moderate amounts of physical activity can greatly improve your mental and physical health. Healthwise recommends brisk walking, for at least 2.5 hours each week, as a good goal. What’s better: You can split this time up in workable sessions to find the routine that best suits you.

Not much of a walker? For more ideas about getting physical, take a look at another valuable Health Options benefit called LifeBalance. This program offers all Members savings on thousands of recreational, wellness, travel, and cultural activities. Whether you are looking to join a gym, find some online fitness classes, or buy some new fitness gear, you can visit HealthOptions.LifeBalanceProgram.com to access great deals for enrolled Community Health Options Members and family members.