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Understanding The Benefits of Health Insurance
Understanding The Benefits of Obamacare
10 essential health benefits

10 essential health benefits must be provided which include mental health care, maternity care, and prescription drugs

Preventative services are free

Preventative services are free, which include: immunizations, contraceptives, cancer screenings, STI testing, pelvic exams, others

can't be denied coverage

Individuals with pre-existing conditions can't be denied coverage or charged a higher rate

You may qualify for a subsidy

You may qualify for a subsidy, which helps reduce the monthly cost of your health plan

can remain on their parent's insurance plan

Young adults can remain on their parent's insurance plan until age 26

coverage limits

No lifetime and annual coverage limits

Which Type of Plan Is Right for You?

HMO, PPO, EPO, or POS: Which Type of Plan Is Right for You?

The type of insurance plan you pick determines how many providers will be covered under your plan and whether you'll need a referral from your Primary Care Doctor (PCP) before seeing a specialist (e.g dermatologist, cardiologist, radiologist).

Types of Major Medical Plans
Do specialists and procedures require a referral?Do I have to stay in-network to get coverage?Is it for me?
HMOHealth Maintenance OrganizationYesYes(Except for emergencies)If you want more provider options and don’t want to have to deal with referrals.
PPO Preferred Provider OrganizationYesNo(In-network care is less expensive)If you want more provider options and don’t want to have to deal with referrals.
EPO Exclusive Provider OrganizationNoYes(Except for emergencies)If you want lower out-of-pocket costs but don’t want to have to deal with referrals.
POS Point-of-Service PlanYesNo(In-network care is less expensive; referral needed for out-of-network)If you want more provider options and a primary care doctor that coordinates your overall care.

Obamacare Metal Plans: What They Are, How They Work

There are 4 different coverage levels, often referred to as “metal plans” because of their corresponding names: Bronze, Silver, Gold, and Platinum. They all offer the same essential health benefits. The main difference among Bronze, Silver, Gold, and Platinum plans is how much you pay for care versus how much your plan covers.

Learn More About Metal Plans

Bronze

Insurance Company Pays 60%

Silver

Insurance Company Pays 70%

Gold

Insurance Company Pays 80%

Plantinum

Insurance Company Pays 90%

Read our guides

Health Insurance for the Unemployed: Obamacare or COBRA?

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A Step-by-Step Guide to Buying Individual Health Insurance

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