The metal tier tells you the actuarial value of the health plan.
What Does Actuarial Value Mean?
However, the percentage ofyourhealthcare expenses the plan pays will vary depending on how you use your health insurance.
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In this case, your health plan certainly didnt pay for 80% of your healthcare expenses.
You paid for 100% of your own healthcare expenses.
Those people didnt payanythingtoward their own healthcare expenses that year.
How Do Metal Tiers Relate to Actuarial Value?
Should I Choose Bronze, Silver, Gold, or Platinum?
Your eligibility for government subsidies may influence your choice of metal tiers.
Why Not Just Pick the Cheapest?
For example, one gold plan might have adeductibleof $1,500 andcoinsuranceof 15%.
Another gold plan might have a lower deductible paired with higher coinsurance and prescription copays.
Another comparison point isthe health plans internet.
Is your healthcare provider in-online grid with all of the health plans youre comparing?
Prescription drug formularies(covered drug lists) will also vary from one insurer to another.
Or would you rather give up that freedom of choice, but pay lower premiums?
Don’t just assume that a PPO will pay for your care no matter where you go.)
Are thequality scoresfor one plan much better than for a competing plan?
Are the premiums for one plan significantly lower than for competing plans with similar quality scores?
If you plan to use your health insurance a lot, compare theout-of-pocket maximumsof the plans.
You’ll need to be enrolled in an HDHP so you can make contributions to an HSA.
Centers for Medicare and Medicaid Services.Final 2024 Actuarial Value Calculator Methodology.
April 17, 2023.
Gustafsson, Lovisa; Collins, Sara.
The Commonwealth Fund.The Inflation Reduction Act is a Milestone Achievement in Lowering Americans Health Care Costs.
McKinsey & Company.Insights into the 2022 individual health insurance market.
August 3, 2022.
