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Government Health Plans: Affordable and Accessible Health Care for All

Government Plans were established by the Affordable Care Act to provide every American with quality health coverage that is truly affordable and attainable.

There are four types of Government Plans. Known as the “metal plans,” they are categorized as

  1. Bronze,
  2. Silver,
  3. Gold, and
  4. Platinum.

There is also a fifth plan that is known as the Catastrophic Plan. It provides limited coverage at a low cost for emergencies and serious medical events.

What Do Government Plans Cover?

Each of the four metal plans -- Bronze, Silver, Gold and Platinum -- provides you with the Essential Health Benefits that are required by the Affordable Care Act. These include:

  1. Ambulatory patient services.
  2. Emergency care.
  3. Hospitalization.
  4. Maternity & newborn services.
  5. Mental health and addiction services.
  6. Prescription drug coverage.
  7. Rehabilitative and habilitative care.
  8. Laboratory services.
  9. Preventive and wellness services, along with chronic disease management.
  10. Pediatric care, including dental and vision services.

You are entitled to health coverage with a Government Plan whether or not you have a preexisting medical condition. You also cannot be dropped by your carrier for becoming too costly to insure.

Government Plans are available only during Open Enrollment. The only exception is if you missed Open Enrollment, you could be eligible for a Government Plan if you have a Qualifying Life Event-- or certain life changes.

What are the Difference Between Government Health Plans?

The difference among plans is the cost. Each plan provides you with access to the same level of coverage. Please review the below table to compare the differences:

Plan Type Monthly / Annual Rate Subsides Accepted? Insurance Pays You Pay Best for those who:
Bronze: Low Yes 60% 40% Do not expect to regularly see the doctor or take prescriptions.
Silver: Medium Yes 70% 30% Do not expect to regularly see the doctor or take prescription drugs. However, my preference is to pay less out-of-pocket when I do need care or medication.
Gold: High Yes 80% 20% Expect to regularly see a doctor and regularly take prescription medications.
Platinum: Premium Yes 90% 10% Have an on-going medical condition or illness requiring very frequent medical services and medications.
Catastrophic:
available only for those under 30 or with a hardship exemption
Lowest No 90% 10% Meet the eligibility requirements of an income hardship and/or being under the age of 30. Coverage includes free preventive care and 3 primary care visits per year with no deductible. Entire deductible must be paid before the plan pays for catastrophic medical events.

Qualifying for a Subsidy

Subsidies are like “discounts” that are applied directly towards your health care costs. They can substantially lower the amount you pay for health coverage. You must meet certain income guidelines in order to qualify.

If you do qualify, the total amount of your subsidy will depend on your age, your household income, how many people are in your household, and whether you are a smoker.

Currently, many uninsured Americans qualify for subsidies. To learn about qualifying for subsidies, please click here.

Determining Your Eligibility

Your eligibility for Government Plans and Subsidies can be determined during the enrollment process. Please enter your zip code and fill in the 1-page application to begin. You can also call (844) 992-2717 to speak to an agent.

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GovernmentHealthInsurance.com
700 S. Flower St., Suite 640,
Los Angeles, CA 90017

GovernmentHealthInsurance.com is an independent marketplace and is not a federal or state Marketplace website. GovernmentHealthInsurance.com does not provide quotes or sell insurance directly to consumers, is not affiliated with any exchange, and is not a licensed insurance agent or broker. Accordingly, you should not send us (via mail or email) any sensitive information, including personal health information or applications. Any such communications will not be treated as confidential and will be discarded, as, in offering this website, we are required to comply with the standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information.

This website may not display all data on Qualified Health Plans being offered in your state through the Marketplace website. To see all available data on Qualified Health Plan options in your state, visit your state Marketplace website or go to the Health Insurance Marketplace website at www.HealthCare.gov

Advertised Pricing:

There are several factors that impact your monthly premium; including, but not limited to your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

The advertised price may not be typical. It was generated using the Kaiser Family Foundation's subsidy calculator that was accessed on September 16, 2020. The following parameters were used: 21 year old adult, non-tobacco user, annual income of $24,700 in 2020, no children, and no available coverage through a spouse's employer. The resulting monthly premium was $30 per month (or $360 per year after $2,751 in subsidies) for a Bronze Plan. Even when using the same parameters, this result is subject to change.