Benefits and Coverage

MDwise Marketplace offers three categories of Marketplace insurance, called metal levels. The right plan for you and your family depends on your health and financial situation.

Need help with understanding terms such as copay and deductible?
Here is a list of terms you are likely to see as you review health insurance information.

 

Bronze offers the lowest monthly premium, with the highest cost sharing structure. This means you will have higher out-of-pocket costs, including copays, coinsurance and deductibles. While you will pay less for your insurance each month, it will cost more when you go to the doctor to get care. You may prefer this plan if you are healthy and don’t anticipate many doctor visits or prescriptions.



Silver
 offers the second lowest premium and has smaller out-of-pocket costs than bronze. You can get even lower out-of-pocket costs if you qualify for subsidies. If you qualify for cost sharing subsidies, you must choose a Silver plan to get the savings.



Gold
 has the highest monthly premium but a smaller out-of-pocket maximum. You will pay more for your insurance each month but will pay less out-of-pocket costs. This could be the best choice if you think you will need a lot of medical care and regular prescriptions.

Note: there is a Zero Cost Plan available for Native Americans who are part of a tribe and Alaskan Natives. View a summary of benefits and coverage for this plan.

TIP: Remember, the lower the premium you pay each month, the higher the out-of-pocket costs will be when you go to the doctor for care. If you get in a serious accident or have an unexpected health problem, you will have to pay more of the costs. The higher the monthly premium, the lower the out-of-pocket costs will be when you need care. If you expect going to the doctor often or need regular prescriptions, you will pay less.