Covered California Series: Gold and Platinum Plans Explained

November 20, 2013

The Affordable Care Act (ACA) has changed the way Americans purchase health insurance. Under the terms of the act, each state has established an online marketplace for consumers to purchase insurance. The marketplace is not unlike a major travel website: People can compare different plans and explore the costs and benefits of each.

Plans come in four packages: platinum, gold, silver and bronze. To help you get a better grasp on the options, we’re diving into the details of the two most beneficial plans – gold and platinum — we want to help you get the most out of your healthcare coverage!

The Similarities

All plans offered in the marketplace must meet a certain standard and cover the same things, including:

  • Ambulatory services
  • Care for newborns and children
  • Chronic disease treatment (You can no longer be denied coverage for pre-existing conditionsv)
  • Addiction treatment
  • Emergency care
  • Mental health services
  • Prenatal, labor and delivery care
  • Language therapy
  • Physical and occupational therapy
  • Prescription drugs
  • Wellness screenings and preventative care

Regardless of which plan you choose, all these services are covered.

The Differences

The main difference between platinum and gold plans is cost. Platinum plans have a higher monthly premium (the price you pay for insurance whether you use it or not), but also cover a higher percentage of your medical care. This plan lowers your out-of-pocket cost for:

  • Deductibles: the amount of money you need to pay before your insurance kicks in

  • Co-pays: a set amount you pay for services

  • Co-insurance: your share of any treatment or service covered by the plan

A platinum plan can be counted on to cover about 90% of your medical costs, while a gold plan covers approximately 80%.

A gold plan will save you money each month, but it might not be the best option in the long run. A relatively healthy person might find a gold plan adequate; those with chronic health conditions will likely benefit

Which Plan Is Right for Me?

The decision completely depends on you and how much coverage you want or need. A healthy person who rarely visits the doctor and doesn’t expect to need much care in the future could save money each month with a gold plan or the bronze or silver options. Keep in mind that health crises can pop up suddenly, and the underinsured may wish they’d sprung for the platinum plan from the beginning.

Choosing the right level of health care coverage isn’t easy. But Terpening Insurance can help! To find out more about the Covered California plan, see our extensive resource guide and Contact us today. We’ll be sure you get the best rate and plan for your individual needs.

Post author Loren Pleet