How to Choose Insurance Coverage in the Marketplace

Posted Oct 4, 2013 | Posted in News & Events

Online Health Care EnrollmentThis week, the Health Insurance Marketplace opened for business as part of the Affordable Care Act.  For many of the 1.5 million uninsured residents of North Carolina, this means that they will now have the opportunity to get health insurance, possibly at free or reduced rates.  If you are uninsured, underinsured, or simply want to explore other options for insurance coverage, there are many plans to choose from in the marketplace.


Since the North Carolina marketplace is being run through the federal government, residents of Johnston County and all of North Carolina can enroll through

Here is a breakdown of the four levels of plans that are offered and how to choose the one that’s right for you.


Insurance pays 60%
You pay 40%

A bronze plan is generally best for someone who is healthy and needs little care throughout the year.  You will have a low premium, so you will save on monthly payments compared to a gold or platinum plan.  If you do need healthcare services, like a checkup or prescriptions, you will end up paying a little more in out-of-pocket expenses. However, if those needs are kept to a minimum throughout the year, you will probably end up paying less than with a high-premium plan.


Insurance pays 70%
You pay 30%

A silver plan will have slightly higher premiums than a bronze plan, and is still a good choice for someone who has an overall healthy lifestyle and no major medical needs.  This type of plan would be a good choice for someone who might need ongoing prescriptions, or more frequent doctor’s appointments. The higher premium will allow you pay less in out-of-pocket expenses for these services, but will still offer affordable monthly payments.


Insurance pays 80%
You pay 20%

A gold plan is best for someone who needs frequent medical care throughout the year. If you need several prescriptions, have ongoing appointments and checkups, or are living with a chronic disease, this type of plan will reduce your out-of-pocket expenses for each of these services. Your premium will be higher than a bronze or silver plan, but with lower costs associated with individual services, you should be able to pay less in medical expenses overall.


Insurance pays 90%
You pay 10%

A platinum plan offers the lowest out-of-pocket expenses and is best for someone who needs consistent medical care for multiple diseases or conditions. This is usually a good choice for the elderly or those in very poor health. While the monthly premium will be higher than any other plan, you won’t have too many additional expenses, since you will only need to pay an average of 10% of the cost of individual services.

Enroll Now

Need help? Find out more information on our website. There are also many sources of help right here in Johnston County. Click here and enter your zip code to find out where you can get in-person help or online and phone assistance to apply, choose a plan, and enroll.


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