Gold Healthcare Exchange Plan Outline of Coverage
What Is the Gold Plan?
The Gold plan is one the Affordable Care Act, AKA ObamaCare, plans. The four plans ranked from least expensive monthly premium to most: Bronze, Silver, Gold, and Platinum*. All plans will all offer the same essential benefits, however additional/extended benefits may be offered by different insurance providers. Gold is one of the plans that must be offered by your insurance provider if they choose to offer any of the plans, the other is Silver. Gold offers comprehensive coverage with predictable out-of-pocket expenses (combination of deductible, copayment, and coinsurance).
*There is also catastrophic coverage, if you qualify.
Gold Plan Overview
The following information below is for individual and family members. Click here to learn about how the Gold plan works for Small Business owners.
- 80/20 split, with you paying 20% for healthcare expenses
- 2nd highest monthly premium. This is without federal subsidies, Do I Qualify for Federal Subsidies?
- Either no or a low deductible
|Benefits||Gold Health Plan*|
|Doctor’s Office Visits||$35|
|Brand RX (Tier 2)||$50|
|Maternity||$600 per day HMO**/20% PPO|
|Out-patient Surgery||$600 HMO/20% PPO|
|Hospital Stay||$600 per day HMO**/20% PPO|
|Out-of-Pocket Max||$6,200/$12,400 (ind/fam)|
**Up to 5 days in the hospital
*The chart above is for California. To learn what insurers cover in your state get a Healthcare Exchange quote.
Is there only one Gold Plan offered?
There may be multiple plans within states. Specific plans will be determined by state leaders and insurance providers.
How Does the Gold Health Plan Compare to the Other New Plans?
Gold will have the 2nd highest monthly premiums, but Gold plan members, due to the 20% co-share, will have lower cost-sharing expenses than a plan with a lower monthly premium. Click here to compare Bronze, Silver, Gold and Platinum health plans side-by-side.
Over 65 and ObamaCare
For seniors over 65, ObamaCare does not work the same. Click here to learn more about the Health Care Exchange and Senior Options.