Medical Care Costs
Bonus: Payment chosen by you that must be made monthly to the company providing your medical coverage.
Deductible: How much you have to pay for covered medical services before your insurance company pays.
Copayments and co-insurance: The payments you make every time you receive a medical service after you reach your deductible.
Maximum out-of-pocket costs: The maximum you have to pay for covered services in a year. After reaching this amount, the insurance company pays 100% for covered services.
Characteristics of the plans in the Health Market that you must take into account before making the choice of your plan. The plans appear in 4 “metal” categories: Bronze, Silver, Gold and Platinum. The categories are based on how you and the health plan share the total cost of your health care.
The categories with the highest premiums are the Gold Plan and the Platinum Plan that pay more than their total health care costs. Categories with lower premiums, such as Bronze and Silver Plans that pay less than their total cost. Remember that the cost of the plans also has a price variation not only for the category of the plan but also for the number of members that make up the family, the dependents and the income of the family group.
It is advisable that you get a Bronze plan if you do not expect to use medical services on a regular basis and do not take prescription medications on a regular basis. These plans may have very low monthly premiums, but they have high deductibles and pay less of the costs when you need medical care.
Silver plans can be a good option. If you qualify for additional savings (“cost-sharing reductions”), your deductible will be lower and you will pay less each time you receive care.
If you expect to make many visits to the doctor’s office or need prescriptions regularly, the best option would be to acquire a Gold plan or a Platinum Plan. These plans usually have higher monthly premiums, but pay more of your costs when you need health care.