Health insurance plans on the marketplace are divided into four categories: platinum, gold, silver and bronze. These categories are based on how you and your health plan split costs. They have nothing to do with quality of care. And all categories offer PPOs, HMOs and other types of plans. How to decide? Consider the following questions.
How much do you expect to spend on healthcare in 2025?
The more you use healthcare services, the higher your costs will be. You may have reasons to anticipate spending more than usual next year, such as having a baby or planning knee replacement surgery. If you have a chronic condition, such as diabetes, you likely have a good idea how much you spend each year.
When it comes to healthcare costs, how much do you value predictability?
In general, with PPO health insurance plans, the higher the premium, the lower your out-of-pocket costs (including deductible, copay and coinsurance) will be. Some people choose a higher-premium plan with a lower deductible, so their spending is more predictable even when unexpected healthcare events happen. Others prefer a lower-premium plan.
Would you trade more choice of providers, such as your current primary care physician and your preferred hospital, for lower costs? Some health insurance plans, such as PPOs, allow you to use many doctors, hospitals and other providers. Others, such as HMOs, limit your choice of providers but have lower premiums and out-of-pocket costs.
A tax credit is available for any marketplace plan at any metal level to those who qualify. To learn more and apply, visit healthcare.gov or call 800-318-2596. Open enrollment ends on Jan. 15, 2025.
Beginner tip
The Marketplace Call Center offers free help 24/7. Call 800-318-2596 to ask a question, start or finish an application, compare plans or enroll. You can search by city and state or ZIP code to find in-person help in your area.
Advanced tip
Wondering if the tax credit might make a marketplace plan cheaper than your job-based health plan? Whoa! If you have a job-based plan now (or get an offer for one), you won’t qualify for savings on a marketplace plan if the job-based plan is considered affordable and meets minimum standards. Most job-based plans meet these standards. The details are at healthcare.gov.