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HomeHealth Insurance Blog › Gold Healthcare Exchange Plan Outline of Coverage

Gold Healthcare Exchange Plan Outline of Coverage

May 11, 2013

By Katie Banks+

What Is the Gold Plan?

The Gold plan is one the new Patient Protection and 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, only available to those under thirty and who are unable afford one of the standardized plans.

Gold Plan Image

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*
Deductible $0
Preventive $0
Doctor’s Office Visits $30
Specialist $50
Generic Rx $19
Brand RX $50
Lab Testing $35
X-ray $50
Maternity $600 per day HMO**/20% PPO
Out-patient Surgery $600 HMO/20% PPO
Hospital Stay $600 per day HMO**/20% PPO
ER Visit $250
Urgent Care $60
Out-of-Pocket Max $6,350/$12,700 (ind/fam)

**Up to 5 days in the hospital

*California was the first to release its Healthcare Exchange details and much of the copay information we know so far are based on their figures. CHART UPDATED 9/26/13. For information about specific details of the Gold health plan in your state call 800-930-7956.

UPDATE 11/27/13: For an easy way to fill out your Affordable Care Act application go to the Obamacare Exchange Healthapplication.com. Remember to fill it out and send it in as soon as possible to ensure the earliest enrollment date.

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.

For any questions or assistance in applying during the open enrollment period: October 1, 2013 to March 31, 2014),  please contact Medicoverage.

 

Open enrollment for the ACA plans (ObamaCare) ends March 31, 2014. Applications must be submitted by Dec 23,2013 if you want to start on January 1st. Apply for an ACA Plan Here

Days left to enroll in ObamaCare plan. Apply Now




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