Gold Plan Under ObamaCare
The Affordable Care Act (ACA), commonly known as ObamaCare, begins its Healthcare Exchange January 1, 2014. The open enrollment for these plans begins October 1, 2013 and ends March 31, 2014, and each plan must offer of ObamaCare essential benefits. Although every plan across the country must offer these benefits, states and providers may still offer additional or extended coverage. The Gold Plan has the 2nd highest monthly premium, but the second lowest cost-sharing costs. Click here to compare Bronze Plan, Silver Plan, Gold Plan, and the Platinum Plan side-by-side.
*Healthcare Exchange Catastrophic coverage is available for those who are under thirty and do not qualify for subsidies.
Below is the most up-to-date information available, as the federal and state governments work to fine tune the details of these plans we will update this article.
Gold Plans*
These Gold plans are specific to individual and family members. Click here to learn about how the Gold plan applies to ObamaCare Small Businesses.
| Benefits | Gold Health Plan* |
| Deductible | $0 |
| Preventive | $0 |
| Doctor’s Office Visits | $30 |
| Specialist | $50 |
| Generic Rx | $19 |
| Brand RX | $50 |
| Lab Testing | $35 |
| X-ray | $50 |
| Maternity | $600 per day HMO**/20% PPO |
| Out-patient Surgery | $600 HMO/20% PPO |
| Hospital Stay | $600 per day HMO**/20% PPO |
| ER Visit | $250 |
| Urgent Care | $60 |
| Out-of-Pocket Max | $6,350/$12,700 (ind/fam) |
**up to 5 days
*California was the first to release its Healthcare Exchange overview, and much of information we know so far is based on their figures. CHART UPDATED 9/26/13. For information about specific details of the Gold Plan in your state call 800-930-7956.
UPDATE 11/27/13: For an easy way to fill out your Affordable Care Act application go to Healthapplication.com. Remember to fill it out and send it in as soon as possible to ensure the earliest enrollment date.
How Much is the Gold Premium?
Premiums depend on age, state, region, provider, and whether you qualify for a federal premium exchange subsidy. With California’s numbers being the first available, the lowest Gold Plan for a 40 year old, non-smoker living in Los Angeles is approximately $276.
Further Questions
For questions about the Gold Plan in your state please contact Medicoverage.
Comments and Questions
Click to leave a CommentComment from Judy on September 23, 2014
When trying to determine which plan to select, and which I can afford, do I have to count my spouses income to determine my cost even if we have separate bank accounts, and separate everything?
MEDICOVERAGE AGENT RESPONSE
Judy,
Thank you for your question. To determine if you qualify subsidies you use your typically use your Household MAGI (modified adjusted gross income). However, for all tax and financial questions we advise that you consult a finance expert for the latest and most up to date information.
-Jacima from www.medicoverage.com
Comment from john fisher on September 27, 2013
My wife and myself are in our 50's,own our home and all the related cost like tax's, ins.,upkeep
and upkeep cost.We have been laid off from jobs for 5 years and have no savings.We do get 2,000 dollars a month from my 401k plan and two old cars with 1,200 a year insurance.
SO MY QUESTION IS HOW DO I THE MONEY FOR ANY HEALTH INSURANCE,WE ARE LIVING DAY TO DAY AND COULD NOT SPEND ANOTHER DIME ON ANYTHING!!!!!!
<strong>MEDICOVERAGE AGENT RESPONSE</strong?
John,
The ACA offers subsidies based on your modified adjusted gross income. If you have very low or no income you could qualify for a Medicaid health plan and would not be required to sign up for an ObamaCare plan. You would want to contact the Medicaid office in your state.
-Chris from Medicoverage.com