The Advantages of Bronze and Silver Health Plans
Formerly, I worked as an advertising salesman for a large cable television company. This was an excellent experience, for I learned to see sales as a needs-fulfillment business. I learned that there is always someone in need of a particular product and service.
On the first day of work, my boss told me: “you are forbidden to sell someone something he does not need.” I adopted this as a mantra, and I have used it in my sales practice ever since. Now I work for American Exchange, and I am proud to say that selling health insurance really does fulfill the needs of consumers.
For starters, taxpayers need to enroll in a qualified health plan to avoid paying a tax penalty. An adult taxpayer faces a minimum penalty of $695 for not enrolling in coverage. This penalty is deducted from one’s tax returns—don’t let this happen to you! In addition, health insurance protects folks from financial hardship. Don’t believe me? Just read this article from the Huffington Post about the consequences of not having health insurance. Besides the obvious practicalities of having health insurance, consumers have different needs in selecting health plans. This article explains the advantages of buying Silver and Bronze plans.
The Advantages of Selecting Bronze Health Plans
A bronze plan is the most basic coverage that insurance companies offer. Usually, these plans have low monthly premiums, yet the plans have high deductibles. The lowest-cost Blue Cross Blue Shield Plans have deductibles in the $5000 range for an individual. This means that one will have to purchase the services of the provider at full price until a consumer spends $5000 or more.
Even though the deductibles are high, the plan still offers valuable benefits. The passage of the Affordable Care Act allows health insurance holders to seek care from doctors two times per year at no charge. Most callers will generally say they see a doctor between one and four times a year. Of these visits, most people will admit that one or two of the visits were out of the ordinary—the consumer just happened to get sick or injured. So, if you already do not go to the doctor often, save money in monthly premiums by purchasing a bronze plan.
Prescriptions coverage is a concern in buying a health insurance plan. Prescriptions can get expensive, for there are some medications out there that cost in the thousands of dollars for a 30 day supply. Most of my callers do not have prescriptions that cost so much, and these callers generally take generic drugs. Without insurance, generic drugs generally cost in the tens of dollars for a monthly prescription. These drugs do not break the bank even when one is paying full price. If you take generic prescriptions, you will save money in the long-run by buying a bronze plan.
In the end, the largest benefit of any health insurance plan is the out-of-pocket maximum. Generally, this number for a bronze plan is between $6000 and $7000 for an individual, but this represents the absolute maximum one will have to pay in medical expenses. I realize that not too many people have $7000 lying around to cover medical expenses, but I would rather owe $7k than $100k in medical expenses any day…
The Advantages of Selecting a Silver Health Plans
Right off the bat, a Silver Plan features better care. More providers accept Silver plans, and the plans offer richer benefits. A consumer who buys into a Silver Plan can expect the plan to feature lower deductibles, but the same person can expect to pay a higher monthly premium.
Blue Cross Blue Shield of Tennessee and United Healthcare both rolled out some great Silver plans that feature very rich benefits this year. Depending on the plan, Blue Cross and United Healthcare offer copays for doctor visits or prescriptions. A copay is a good benefit because it gives the policyholder a flat rate that he has to pay when seeing a doctor or buying prescriptions.
Generally a United Healthcare Silver Compass 2000 and 5000 plans offer prescription copays of up to $160 for the most specialized prescriptions. Generic drug copays under these plans are fixed at $10 for a generic prescription. The same plans feature doctor visit copays of no more than $80 for a specialist (dermatologist, cardiologists, etc.), and a primary care physician would cost the customer $10-$40 (gynecologists, family practitioners, internists, etc.). If one anticipates having more prescription drug and doctor costs, I would advise trading up to a Silver plan.
There is one great benefit added to Silver Plans through the Affordable Care Act. A person may qualify for Cost-Sharing Reductions in premiums, deductibles, or coinsurance in purchasing a Silver plan. A Blue Cross S04S plan offers a $2000 deductible in addition to a $4000 out-of-pocket max to those who do not qualify for tax credits. A 29-year-old, single male with a $15,000 income can purchase the same plan over the Health Insurance Marketplace with a $0 deductible and a $550 out-of-pocket maximum.
Everyone needs health insurance. The purchase of a qualified health plan allows taxpayers to avoid penalties of $695 or greater, and the policies cap the total medical expenditures one could incur. In buying a policy, a consumer should reflect upon the type of care he seeks. If a person rarely pays visits to the doctor, and if he takes generic prescriptions, I would strongly suggest enrolling in a Bronze plan.
For example, a 29-year-old, single male with a $15k household income sees a doctor once a year. He takes three monthly prescriptions, but they are all generic costing no more than $50. Due to his age and income, he qualifies for a Blue Cross Blue Shield bronze plan in Tennessee for $0/month. This young man has the following health insurance costs for the year with Blue Cross:
$0 (free preventative doctor visit) + $0 (free monthly premiums) + $600 (12 months X $50/month prescriptions) = $600/year in medical costs.
The same young man qualifies for a United Healthcare Silver plan for $17/month with prescription copays. Here is a breakdown of his expenses through this plan:
$0 (free preventative doctor visit) + $204 (monthly premium X 12) + $600 (12 months X $50/month prescriptions) = $804/year in medical costs.
Since the young man will not use the richer benefits of a silver plan, it is in his best interest to buy into a health plan with more basic coverage. It will save him $204 in the long run.
Everyone’s needs are different. Call us and we can assess yours!
Philip Strang is an enrollment specialist at American Exchange, and is a Marketplace Certified Agent/Broker. To contact him with any questions or comments you can email him at firstname.lastname@example.org or call at 1-888-995-1674.