The Gold plan is the second highest plan option offered by the Affordable Care Act plans, and incorporates richer benefits for its members. With an actuarial benefit of 80%, Gold Plan members face less out of pocket exposure. The plan will not see a deductible on either its medical or pharmacy benefits, giving members flat co-payments for most of their services. The actuarial value of protection is 80% on the Gold options, leaving only 20% remaining as out of pocket exposure for the insured.
Plan Benefits for the Gold Plan:
- Primary Care Visits are a $30 co payment
- Specialist Visits are a $50 co payment
- Lab Tests cost $30 per procedure
- X-Rays are covered by a $50 co payment
- Complex medical care is covered 80%
- Emergency Room Visits are $250
- Generic Medication will cost $20
- Brand Name medication will cost $50
- There is no deductible on medical care or brand name medications
- The out of pocket maximum for an individual is $6,400; $12,800 for families.
Having more comprehensive coverage does mean a higher price tag for a Gold Plan. Let Health Exchange Quote Insurance Agency help you determine if the Gold Plan is right for you and your family!
You can compare all plans here
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