Affordable Care Act Plans: Premiums & Pay Outs

5:20 PM, Oct 2, 2013   |    comments
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Greensboro, NC-- In NC you have two providers to choose from when it comes to the Affordable Care Act Marketplace. Both of those providers have 4 plans: bronze, silver, gold and platinum.  

According to each one of the plans cover the same essential health benefits: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

The difference is in the premiums and deductibles you pay. Richard Jones from Trion explains,"You can expect to pay higher premiums or monthly payments, but lower co-pays when you go to the doctor. "

An example on the site is if you have a Gold plan, you'll likely pay a higher premium, but may have lower costs when you go to the doctor or use another medical service.
With a Bronze plan, you'll likely pay a lower premium, but you'll pay a higher share of costs when you get care.
Platinum plans will likely have the highest monthly premiums and lowest out-of-pocket costs

The bottom line,  the lower the premium, the higher the out-of-pocket costs when you need care.
The higher the premium, the lower the out-of-pocket costs when you need care.

"In that case you may want a Gold, or even Platinum plan (depending upon your budget) for the lower out of pocket costs.  If you are generally healthy, only go to your doctor a few times a year and have no chronic conditions or regular prescriptions, then a Bronze or Silver plan may be for you.  As a point of comparison, most of the employer sponsored plans (i.e. plans you get at work) that we see in this region would fall in the Silver or Gold categories."

 In North Carolina, the number for the In-Person Marketplace assistance hotline is 1-855-733-3711.


























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