Helpful Information for the First-Time Buyer

Are you buying health insurance for the first time? Are you wondering where to start? This simple guide can help you find the perfect plan.

Do you already have providers that you know and trust?

• Yes. Use our provider search tool to determine whether your trusted doctors and hospitals participate in the networks of the plans you’re considering.
• No. Make a list of providers or types of providers that you would like to see. Use our provider search tool to help you determine which networks those doctors and hospitals are in.

How often do you expect to need care next year?

• A lot. You may want to consider a plan with a higher monthly premium and a lower deductible. With this type of plan, you won’t have to worry about high out-of-pocket costs each time you visit a provider.
• A little. If you don’t think you’ll use your health insurance that much, you may want to consider a plan with a low monthly premium and a higher deductible. Remember, though, that your coverage needs can change unexpectedly. Make sure you're prepared for whatever life brings.

Do you take any prescription medications?

• Yes. Make sure they are included in our formulary (a list of prescription drugs covered by a plan). Note whether there are any special limits or coverage requirements.
• No. It’s still a good idea to review the formulary of any plan you consider. You’ll want to make sure you understand which drugs your plan will cover and how commonly they are prescribed.

Understanding the different metallic levels

When you are shopping on the marketplace for health insurance coverage, you’ll notice that plans are grouped into three categories: Bronze, Silver, and Gold. These metallic categories represent the levels of coverage that plans provide, on average, over time. Generally, low-coverage plans (Bronze) have low monthly premiums and higher out-of-pocket costs. High-coverage plans (Gold), meanwhile, have higher monthly premiums and low out-of-pocket costs.

Here’s a look at how the metallic levels typically work:*

• Bronze plans cover 60% of costs.
• Silver plans cover 70% of costs.
• Gold plans cover 80% of costs.

You will be responsible for paying the remaining percentage for your covered health care services. Here’s an example based on these cost-sharing percentages:

You select a Silver-level plan and receive care that costs $1,000. Your plan covers $700 of the cost, and you must pay $300 out-of-pocket.

*Descriptions of costs and coverage in plan metal levels are approximate and based on required total average payment for costs of covered services. Examples provided are for illustration purposes only and are not reflective of actual plan benefits. Your cost-sharing and plan payment amounts may vary.