Covered California Plan Levels Metal Tiers│Covered California Enrollment Center

Covered California Plan Levels Metal Tiers

When the affordable care act passed private health insurance companies had to reorganize and repackage their health insurance plans into four mandated plan types: Bronze , Silver , Gold  and Platinum . In California , Covered California went even further and ensured that the plans they offered (On exchange plans) were identical plans within the same metal category. This made them easier to compare. 

The most popular plan is the silver plan , as an example , if you choose a silver plan through Covered California regardless of which insurance company you choose the benefits will be exactly the same.  This means it really only narrows the difference to if you prefer an HMO, PPO, EPO or HSP style plan. These different types of Health care networks change the number of doctors and hospitals you have access to .

Additionally the metallic levels (bronze, silver ,gold, platinum) help you figure out which plan has the appropriate level of care that you may need, as well as, how relatively expensive each plan is. The bronze plan is less expensive than the silver plan which is less expensive than the platinum plan. 

Each plan regardless of the insurance company or level provides coverage for the 10 mandated essential health benefits that are required under the affordable care act these are: 

  1. Emergency Services
  2. Ambulatory Services
  3. Hospital coverage
  4. Maternity coverage
  5. Mental health and Substance abuse 
  6. Rehabilitative services
  7. Laboratory services 
  8. Prescription drugs 
  9. Preventive care
  10. Pediatric Services 

Here is a brief summary of the 4 metal tiers as well as the 5th level plan which is the Catastrophic plan. 

Bronze Plan 

Ideal for: People who are healthy and have low expected healthcare costs through the year. In this case people who enroll into this plan are willing to pay more when the see the doctor in order to get a lower monthly premium 

Info:  

  • Free preventative care 
  • High Deductible 
  • High Maximum yearly limit to expenses
  • Copays for the first 3 yearly doctor’s visits 

Silver 70 Plan 

Ideal for: This plan is the best all around plan, it is a good balance between healthcare costs and monthly premiums. It is good for the average family who expects to have average healthcare costs 

Info: 

  • Free preventative care 
  • Most day to day services are covered with set copay 
  • Deductible and Maximum yearly limit are in the middle of the road when compared to other plans

Gold Plan 

Ideal for:  This plan is ideal for families who may have higher than average medical cost or prefer to spend more monthly in exchange for lower copays when they go see the doctor. 

Info: 

  • Free preventative services
  • Lower copays than silver for day to day medical usages
  • Has no Deductible 
  • Out of pocket maximum limit is the same as the Silver plan

Platinum Plan 

Ideal for : This plan is ideal for families who are anticipating having high medical usage costs through the year. It has a higher monthly premium but one of the lowest costs for medical services 

Info: 

  • Free Preventative Care 
  • Lowest Copays for day to day services
  • No deductible
  • Lowest Maximum yearly limit

 

We are the Covered California Enrollment Center, your place to get free assistance with your health insurance plan. We can assist you to sign up, enroll and update your private health Insurance, Covered California plan, Medi-Cal, Obamacare and Medicare insurances. Our California agency is certified by Covered California, to assist you in-person, over the phone or online in English and Spanish

We specialize in individual and family health insurance plans, Medicare, Medicare Advantage plans, Medicare Supplement (MediGap plans), Medicare Prescription Drug plans (Part D), as well as, Dental and Vision coverage. We can help you get enrolled into health insurance plans, compare healthcare options, provide required health coverage tax documents and review the plans that best fit your budget and healthcare needs.  

Call us today at 844-367-6555 for free assistance over the phone, visit our website at www.EnrollSocal.Com to make an appointment at our California Enrollment Centers Serving San Diego County, Los Angeles County and Imperial County. 

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