What Burritos and Enchiladas Have to Do with Health Coverage

Enrollment Unscrambled

burritoHow many of you have Googled the question, “What’s the difference between a burrito and an enchilada?” An enchilada is made with a corn tortilla, whereas a burrito is made with a flour one. Similarly made, yet a touch different.

Just like food, sometimes determining the differences between things can be daunting. We get it. But when you’re picking out something that’s a big deal, like health coverage, it’s important to understand what you’re buying. Health plans are all under the same umbrella, but we’re here to help you learn the differences between them so you can shop smart for your family.

First up in our health literacy series is plan metal levels, which are the same as plan categories.

Plan categories = Metal levels

metal levelThere are several categories of insurance plans: metal levels called Bronze, Silver, Gold, and Platinum, as well as Catastrophic plans. Plans in these categories differ based on how you and the plan share the costs of your care.

If you opt for a higher metal level, you will generally pay more monthly but pay less later if you run into healthcare needs. This includes low to no copays for your primary doctor, urgent care visits and more. The metal categories have nothing to do with the amount or quality of care you get.

Plans (from lowest upfront cost to highest):

  1. Catastrophic plans: These are available only to people under 30 and people with hardship exemptions. Catastrophic health plans have a low premium but very high out-of-pocket costs.
  2. Bronze plans: Lower monthly payments, but higher out-of-pocket costs (plan covers an average of 60% of costs / you cover 40%).
  3. ***Silver plans: Monthly payments lower than a gold plan, but more than bronze. Your out-of-pocket costs will be less than a bronze plan, but more than a gold plan, unless you're eligible for cost sharing reduction (plan covers an average of 70% of costs / you cover 30%).
  4. Gold plans: Higher monthly payments, but lower out-of-pocket costs (plan covers 80% / you cover 20%).
  5. Platinum plans: Highest monthly payments, lowest out-of-pocket costs (plan covers 90% / you cover 10%).
Source: http://www.cigna.com/individuals-families/understanding-health-care-reform-metal-levels
Source: http://www.cigna.com/individuals-families/understanding-health-care-reform-metal-levels

***Important note about Silver plans: If you qualify for cost-sharing reductions (lower out-of-pocket costs like deductibles and copays), you can access these savings only if you choose a Silver plan. Although Bronze plans have a lower monthly payment, if you’re eligible for cost-sharing and choose a Silver plan you’ll pay less overall than if you went with a Bronze plan.

About Maryland Health Connection

Maryland Health Connection is Maryland’s official health insurance marketplace for individuals and families to compare plans and enroll in health and dental coverage. It’s the only place to get financial help with health insurance. See if you qualify for financial help like tax credits or Medicaid/MCHP to make health insurance more affordable.

Visit MarylandHealthConnection.gov to enroll, or download our free mobile app. Open Enrollment for 2017 is Nov.1 to Jan. 31.

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