When you buy health insurance, you can choose from four categories called “metal levels”—Bronze, Silver, Gold or Platinum. These have nothing to do with the quality of care. Instead, the differences are based on how much each plan will pay for covered costs, compared to what you’ll pay.
It works like this: Bronze levels have the lowest sticker price, or monthly premium, but the highest out-of-pocket cost to you when you need care. Meanwhile, you’ll pay more up front for Silver, Gold and Platinum, but you’ll pay less when you need care.
And keep in mind there’s a fifth choice—Catastrophic plans with low premiums and very high out-of-pocket costs protect those under 30 or those with a financial hardship exemption against the costs of a serious injury or illness.
If you’re expecting to have a healthy year, it might seem Bronze is the way to go. But not so fast.
Depending on your household’s income, you could get premium tax credits or cost-sharing reductions through Maine’s online health insurance marketplace, CoverME.gov. If you qualify, you can use those to help offset the higher price of a Silver plan—while having lower out-of-pocket costs and leaving more money in your pocket at the end of the year. (If you think you can only afford a Catastrophic plan, it’s worth comparing whether Bronze or Silver is a better value if you quality for premium tax credits.)
Think about how you (and your dependents) will use your insurance in the coming year, like this:
Silver, Gold or Platinum might be for you if:
Bronze might be for you if:
Importantly, ALL Community Health Options’ plans offer preventive care at no cost, including yearly wellness checks. Many plans also offer an array of low-to-no-cost benefits that help offset many healthcare expenses (like wellness visits, prescription benefits, and vaccines), even for people with chronic conditions. All non-HSA plans offer Amwell® urgent care telehealth visits with $0 cost sharing.
While costs are important, make sure you choose coverage that fits your needs and gives you peace of mind. For information or to get help choosing a plan, call Member Services at (855) 624-6463.
Follow @communityhealthoptions on TikTok for quick tips and tricks on how to buy and use a health plan. And don’t forget to follow Community Health Options on LinkedIn, Facebook or Instagram.
Need help understanding insurance terms? Here’s a handy guide.
Many of us are waiting weeks or months to book medical appointments. Or taking a long drive to get to the only provider taking new patients—often more than an hour away. And once in the office, chances are we’re spending more time in waiting rooms just for a routine appointment.
The national shortage of healthcare workers has been well-documented, and Maine is feeling it, too, with access to providers emerging as one of the greatest barriers to treatment. By the end of 2022, Maine had just 580 doctors practicing family medicine, an 18% decline from 2019, according to The Portland Press Herald, leaving fewer doctors for a growing population.
During the pandemic, patients discovered the convenience of telehealth and began meeting with their providers through a phone call or video chat from the comfort of their own homes. The concept certainly wasn’t new—Community Health Options Members had access to Amwell® behavioral telehealth well before Covid-19 struck.
That concept has expanded to virtual primary care, giving people the option through an online care team, expanding access to care. Alongside its traditional provider network, Community Health Options now offers Members 18 and older the option to choose a virtual-first primary care team through Firefly Health.
When it comes to health outcomes, many studies have shown patients miss fewer virtual appointments, helping them to stay on track with their health needs. And in a recent pilot program, Walmart employees with diabetes who used virtual care saw a 24% average reduction in glucose levels and patients with hypertension had a 14% reduction in blood pressure, the company said in 2023 when it expanded its program to Maine, among other states.
