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Gold Plan


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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30101 Town Center Drive, Suite 109
Laguna Niguel, CA 92677

Telephone: (800) 366 2751


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