Paggawa ng isang Plan Pinili

Kapag pumipili ng isang plano:

  • Suriin ang iyong kasalukuyang mga pangangailangan medikal kasama ang mga medikal na kasaysayan ng iyong pamilya ang pagkuha ng isang malapit na pagtingin sa dalas ng mga pagbisita sa doktor, specialty care and prescriptions
  • How much would you spend on medications you are currently taking?
  • What is your current household income, any anticipated changes?
  • How much can you afford to pay for out-of-pocket medical expenses (includes premiums and cost shares) considering other budgeted obligations
  • What are the deductible levels that would need to be paid before insurance kicks in
  • Consider making a sample budget or using a comparison chart to evaluate your plan options.

Keep in mind that paying a slightly higher premium for a plan that provides lower out-of-pocket costs and a higher percentage of coverage throughout the year may prove to be more cost effective in the long run.

Marketplace Plan Coverage options:

Marketplace plans are categorized by metal levels to help easily distinguish coverage levels. Each plan is designed to pay a percentage of the total medical bills up to its defined out-of-pocket maximum.

  • Bronze plans are designed to cover a minimum of 60 porsiyento of the medical bills
  • Silver plans will cover a minimum of 70 porsiyento of medical bills
  • Gold plans will cover a minimum of 80 porsiyento of the medical bills
  • Platinum plans will cover a minimum 90 porsiyento of the medical bills

After you reach your plan’s established out-of-pocket maximum, every plan will pay 100% of the plan’s negotiated amount for covered medical care.

FAST FACT:There are no family policies sold through the marketplace. Each consumer receives insurance coverage as an individual and has their own policy, even if plans are purchased at the same time. The only exception is for newborn care, which will be covered temporarily under the mother’s policy.

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