Looking to buy a new Health Insurance Plan During Upcoming Unwinding SEP? Here are the Options You Can Consider!

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With the announcement of the upcoming “unwinding SEP,” millions of Americans will lose their healthcare coverage. This will leave them searching for a new plan that matches their healthcare needs and budget. This is something that many people might not have done for years due to the continuous enrollment period that was announced during the COVID-19 pandemic. With this continuous enrollment period coming to an end this March 31, 2023, the CMS has announced a special enrollment period, known as unwinding SEP, for people losing their coverage. During this period, people who will lose their Medicaid or CHIP coverage can search and apply for a new coverage plan on the Marketplace.

In this article, we will look at the types of health insurance plans available on the Marketplace and briefly discuss their benefits and cost to help you make a choice.

Different Categories of Health Insurance Plans

You can see four categories of plans available on the Marketplace: Bronze, Silver, Gold, and Platinum. In addition, some people can also be eligible for an additional category known as “Catastrophic plans.” These categories differ in terms of their costs and other benefits. Here is a brief comparison of each of these plans to help you see which type of plan is the most suitable for you:

• Bronze

Company Pays: 60%

You Pay: 40%

With a Bronze plan, you will need to pay the lowest monthly premiums, but you will bear most of the expenses when you need medical care. Bronze plans have the highest deductibles, which means you might need to pay thousands of dollars for the care you receive before your insurance company starts to pay its share. This is a good choice if you want to pay the lowest monthly premiums and do not need frequent medical attention.

• Silver

Company Pays: 70%

You Pay: 30%

With a silver plan, you will need to pay reasonable monthly premiums and be responsible for moderate expenses when you need medical care. With this plan, the deductibles are usually lower than Bronze plans. The good thing about the Silver category is that with these plans, you can become eligible for a “Health Savings Account,” which can help you save extra bucks. The silver plan is for you if you are willing to pay slightly higher monthly premiums than the Bronze plans to get more of your routine care covered.

• Gold

Company Pays: 80%

You Pay: 20%

With a Gold plan, you will need to pay higher monthly premiums than the bronze and silver plans and bear low expenses when you need care. With a Gold plan, you will need to pay low deductibles before the company starts to pay its share. A Gold plan is a good choice if you need frequent medical care and can bear high monthly expenses.

• Platinum

Company Pays: 90%

You Pay: 10%

With a Platinum plan, you will need to pay the highest amount for monthly premiums. You will need to pay the lowest amount when you receive medical care. These plans have the lowest deductibles, and the company will start to pay its share earlier than the other plans. Platinum plans should be your go-to category if you need regular medical care and can afford to pay the high monthly premiums.

• Catastrophic Plan

The catastrophic plan is for people who are under the age of 30. Catastrophic plans low have premiums, and you will get free preventative care before meeting your deductible. You will also get three physician visits before your deductibles start to apply.

Different Types of Insurance Plans

Following are the four common types of insurance plans that are offered by different insurance companies:

1. Health Maintenance Organizations (HMOs)

Health Maintenance Organizations or HMO plans will provide you with numerous healthcare services through their network of providers. These plans include a range of preventative services that are not available in other plans. However, with this plan, you will be only covered if you visit the healthcare providers available on the company’s network list. Your primary physician can also refer you to a specialist if needed. But if your preferred doctor is unavailable on the network, you will have to pay from your pocket for the treatment.

With HMO plans, you will need to pay deductibles and co-pay. Out-of-pocket expenses are lower with these plans. Choose this plan if you are looking for preventative care, low monthly premiums, and little to no deductibles. In addition, you will need to provide additional documentation to file a claim.

2. Preferred Provider Organization (PPO)

With a PPO plan, you will have relatively more freedom to choose your healthcare provider than with an HMO plan, and you will not need a referral to seek a specialist’s treatment. For this reason, PPO plans are very popular among individuals and families. With this plan, you can also get care from a healthcare provider who is not available on the company’s network. However, the cost of receiving treatment from an out-of-network will be higher, and you will need to fulfill the required paperwork for this process.

3. Point of Service (POS)

The Point of Service plan can be considered a hybrid of PPO and HMO plans. This plan offers you more freedom to choose the healthcare provider than the HMO after filling out a moderate amount of paperwork. With this plan, a primary care physician will refer you to a specialist if needed, for which you will have to pay a little more.

4. Exclusive Provider Organization (EPO)

If you choose an Exclusive Provider Organization plan, you will only get covered for treatment you receive from the doctors, specialists, and hospitals available on the network. If you need to see a doctor or a specialist that is not present on the network, you will need to pay the entire medical bill unless there is a medical emergency. In addition, with an EPO plan, you will not need a referral for specialist treatment and will have lower monthly premiums.

Contact Us

With all the available options it can be difficult to navigate the health insurance industry. That’s where we can help! Here at Find The Plan, we can help you find a plan that fits your specific needs as well as your budget. Get in touch with us today and let us know how we can help. Our services are free for you to use and we can compare all carriers in your area with you.