Health Insurance Benefits

Coverage Options

Related Information

Individual and Family Plans

Except for short term plans all plans follow the Affordable Care Act guidelines and provide the same set of essential health benefits, quality and amount of care. The differencesare how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costsare.

Platinum Plans

Platinum Plans have the highest monthly premium and often the lowest out-of-pocket costs. In most cases, platinum plans cover 90% of costs, while you cover 10%.

Gold Plans

Gold Plans have a higher monthly premium and often lower out-of-pocket costs than silver plans. In most cases, gold plans cover 80% of costs, while you cover 20%.

Silver Plans

Silver Plans have slightly higher monthly premiums and often lower out-of-pocket costs than bronze plans. In most cases, silver plans cover 70% of costs, while you cover 30%.

Bronze Plans

Bronze Plans have the lowest monthly premium and often the highest out-of-pocket costs. In most cases, bronze plans cover 60% of costs, while you cover 40%.

Catastrophic Plans

Catastrophic health care plans are available for people under 30 and to some low-income people. A catastrophic health insurance plan has a lower premium than other health plans, but has a high deductible. It is meant to serve as a "safety net" to cover large medical costs in case of a serious illness or injury.

Short-Term Health Insurance

Short-term health insurance can give you temporary coverage for 1-11 months. It covers many of the most costly health care services and keeps you and your family protected.

Medicare and Retirement

You can think of Medicare as a safety net. But even a safety net can have holes. Medicare covers many of your health care expenses. But it was never designed to pay all your health care costs. If you rely only on it to cover all of your medical and/or prescription drug expenses, you could come up short. Enhancing Original Medicare can help protect you against some of the expenses it doesn't cover. The plan choices of Blue Cross Medicare Options are offered to do just that.

Employer Offered Plans

Many people get health coverage through their employer. This is called group coverage. Employers usually offer several types of coverage to choose from, and employees get a chance to change their coverage once a year during open enrollment. The three most common types of health plans are health maintenance organizations (HMOs), preferred provider organization insurance plans (PPOs) and consumer directed health insurance plans (CDHPs). Learn more about different types of coverage.

Understanding Health Insurance 

Health insurance is designed to help protect you against the high costs of health care. It works similarly to other types of insurance — you pay a premium (payment) in exchange for the insurance company's promise to pay certain costs in the event of something unexpected. But health insurance also works a bit like a warranty from a car dealership — it also pays for routine maintenance to make sure you stay well and fixes minor things that go wrong from time to time.

Understanding health insurance will help you decode the maze of health insurance options available today. From the new health care law to HMOs and PPOs to Medicare and drug coverage, learn the facts so you can make more informed choices about your health care coverage and your future.

Getting Health Insurance

You can get health insurance through an employer or purchase it yourself. There are many types of insurance for different needs and situations. Get the basics on getting health insurance.

Health Care Reform

The new health care law — called the Affordable Care Act — was passed in 2010. The law is changing the way some Americans get health coverage. Some changes are happening now. The biggest change for consumers comes in 2014, when almost everyone in the U.S. will be required to have health insurance. Learn more about how health care reform may affect you.

Types of Coverage

Knowing what is covered ahead of time is a key to finding the right plan for you. From medical care to prescriptions to dental or vision, learn about the types of health coverage available to you.

Types of Health Insurance Plans

You've heard terms like PPO, HMO and deductibles, but what does it all mean? Get the health insurance information you need to make your best choice with this guide to different types of health plans.

Glossary of Terms

Some insurance and medical jargon may make understanding health insurance difficult.View a glossary of common health insurance terms.


How to Shop for Health Insurance

Starting in 2014, most people will be required to have health insurance or pay a penalty. Coverage can be through your employer, an insurance company, a government program such as Medicaid or Medicare, or insurance bought on the health insurance exchange.

Some people will be exempt from the requirement to have health insurance, including:

  • People who would have to pay more than 8 percent of their income for health insurance
  • People with incomes below the threshold required for filing taxes (in 2012, $9,750 for a single person and $27,100 for a married couple with two children)
  • People who qualify for religious exemptions
  • Undocumented immigrants
  • People who are incarcerated
  • Members of Native American tribes

Choosing a health insurance plan is a big decision. The right plan has to be the ideal balance of cost and coverage. Visit the Shopping Guide for more information on how to shop for a plan.

Can I Afford It?

With health coverage, premiums are just one factor to consider. There are many ways you can reduce your overall costs so you can afford what you need. Learn about your costs and options here.

Understanding Costs

It’s important that you know how your health coverage plan works so that you are aware of potential costs. Learn about how coverage works and explore typical cost scenarios.

What Is and Isn’t Covered

Finding out what is covered—and what isn’t—will be a key factor in your decision. Learn how to choose a coverage plan that gives you the coverage you need.

Questions to Ask When Choosing Health Coverage

Picking a health coverage plan doesn’t have to be complicated. Part of making the best choice is knowing what questions to ask. Learn what questions to ask before making your decision.

Keeping Your Health Care Costs Down

Now that you are more familiar with what’s included in health care expenses, it’s time to manage your own costs and save money. From picking the right health coverage plan to budgeting, here are some tips to help you keep your health care costs down.

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