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How Metal Tiers in Health Insurance Policies Can Affect Your Coverage
Updated: Apr 28, 2022
The Winter Olympics may be in the rear-view mirror, and all the Olympics fanatics out there will have to wait another two years to watch their favorite athletes compete on the world stage. While we won't be seeing snowboarding, curling, or cross-country skiing for a while, metal tiers are still very much a part of daily life.
Metal tiers are used in countless industries to distinguish various perks packages. In the airline industry, frequent flyers can attain higher statuses –– like gold or platinum status –– which upgrade benefits or access to airport lounges. Metal tiers aren't exclusively limited to the Olympics and airlines; however, health coverage comes in bronze, silver, gold, and platinum plans.
In this blog, the team at Trusted Referral Network will decipher the meanings between bronze, silver, gold, and platinum plans, plus how these metal tiers can affect your health insurance coverage and your health insurance costs.
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The Metal Tiers of Health Insurance Plans
Bronze Health Insurance Plans
Silver Health Insurance Plans
Gold Health Insurance Plans
Platinum Health Insurance Plans
Bronze Plans
As is the case with the Olympic podium, a "bronze" typically refers to the lowest (or most basic) tier of health insurance plans. A bronze health insurance plan typically has lower monthly premiums but is reserved for individuals who are very healthy and only need an occasional doctor's visit. This metal tier is not for elderly individuals, and if you are buying a bronze health insurance plan for your family, children cannot participate in dangerous activities. Those opting for one of these health insurance plans can expect to pay 40% out-of-pocket medical costs, with the other 60% covered by the plan.
Silver Plans
With slightly more coverage than a bronze plan, a silver plan is for those that are still fairly healthy but may require prescription drugs or more frequent doctor's visits. Children on family silver plans still cannot participate in risky activities (such as contact or action sports,) and family members must be under the age of 70 and in good health. Under a silver plan, out-of-pocket expenses for healthcare services are typically 30%, and the health plan covers 70%. Its policy-holders can expect moderate monthly premiums.
Gold Plans
Suppose you or a family member has a chronic condition that may result in high out-of-pocket costs. In that case, this plan can make costs more bearable while still providing policy-holders with access to the proper healthcare services. Individuals at a higher risk of cold, flu, or seasonal illness that may require more regular healthcare services may also benefit from the coverage a gold plan offers. Parents with young children can also benefit from a gold plan, as a gold plan offsets the cost of routine pediatrician visits. Under gold plans, policy-holders can expect to pay 20% out of pocket with 80% of costs covered by the policy.
Platinum Plans
While the pinnacle of Olympic success is the gold, there is a tier of health plans above the gold plan: platinum plans. Reserved for individuals with severe, chronic illnesses on several medications, platinum plans require policy-holders to pay 10% of out-of-pocket costs, with 90% of the costs being covered by the insurance company. These out-of-pocket costs are virtually insignificant compared to the cost of care, as individuals on a platinum insurance plan typically need urgent or emergency care multiple times a year in addition to costly prescription drugs. These health costs can add up, and platinum plans are a great option for offsetting hefty medical costs.
Which Insurance Plan is Right for You?
When shopping for the right health plan for you or your family, it can be hard to decide which insurance plan to choose. While those with high medical costs may benefit from bronze plans or silver plans, bronze plans will not be the right choice for those suffering from chronic illness –– who will undoubtedly see the benefits of gold plans and platinum plans.
Trusted Referral Network knows that the metal tier system can be confusing, so we have a collection of resources designed to help you find the right health plan for you and your family. There are countless health insurance options out there, and we can help connect you with health insurance companies that have affordable coverage for your specific needs.
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