Finding the perfect insurance plan is difficult for consumers. Each family is different, with specific consideration when going through the selection process. While cost will always be a consideration, it shouldn’t be the only thing on consumers mind when choosing a plan to fit the whole family. At Absolute Best Insurance in Palm Beach County, we have compiled a short explanation for the differences between short term health insurance and the ACA tiers. Read on to learn more.

ACA Tiers Explained

In ACA plans there are four tiers that are used for cost-sharing purposes between the individual and the health insurance agency. When these metal tiers are used, the services covered and potential level of care are not accounted for. The metal tiers under ACA are called: Bronze, Silver, Gold, Platinum and all of them offer the following core benefits including but not limited to:

  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care
  • Mental health and substance use disorder services
  • Prescription drugs
  • Lab services
  • Preventive and wellness services, chronic disease management
  • Pediatric services

The major difference between tier levels for the beneficiary is the cost, and remember that whether the individual chooses a metal tier or a short term plan from their health insurance agency, it will not cover everything.

Short Term Health Insurance 

In essence, short term health insurance is designed to fill in the gaps for coverage while in between a typical healthcare plan. If one has lost their job, or leaving their parents insurance, or simply in between jobs, they may be the perfect candidate for short term health insurance.

Beneficiaries can expect benefits to include:

  • Emergency room visits
  • Anesthesiology and surgical care
  • Diagnostic services
  • Ambulance Services
  • Routine doctor office visits

With the repeal of the individual mandate in full effect, one can more easily switch to a short term health insurance plan from their ACA tiered plan. Clients may be more attracted to a short term option because of benefits like reduced premiums, no enrollment periods, customizable plans, and the absence of network limitations. Go over all the pros and cons with the clients so they can pick what’s best for them and their family.

Keep in mind that you should always do what’s best for the client’s short and long-term needs. A fully informed client should know that the short term health insurance plans offer limited coverage, and are ultimately not comparable to ACA tiered plans when it comes to benefits from their health insurance agency. Also be sure to inform clients that short term plans do not cover pre-existing conditions.

Contact Us

Finding the perfect health insurance plan is never easy. Clients need to find a plan that fits their individual needs as well as their family’s. When you go over the pros and cons of short term plans, explain to clients the difference in health insurance they will receive in comparison to the much more comprehensive ACA metal tiers. For more information, contact the professionals at Absolute Best Insurance. From the moment of our establishment, we have sought to provide exemplary service to the good people of Palm Beach County. For a health insurance agency you can trust, call or visit us!