Bronze
A Marketplace plan category with its own balance between monthly premium and the costs you may pay when receiving care.
Health Insurance
Coverage built around your life.
Health insurance is about more than choosing a monthly premium. Doctors, prescriptions, family needs, provider networks and out-of-pocket costs can all shape the plan that works for you.
Individual and family health insurance guidance.
A plan should fit more than a price
Your doctors
✓
Your prescriptions
✓
Your healthcare budget
✓
Your family needs
✓
Before You Choose
Look beyond the monthly premium.
01
Providers
Doctors, hospitals and specialists.
02
Prescriptions
Drug coverage and plan formularies.
03
Total Cost
Premiums and out-of-pocket costs.
04
Household
Coverage for you and your family.
Choosing Health Coverage
The right plan starts with how you use care.
Two plans can have similar premiums and still work very differently once you need medical care.
Provider networks, deductibles, copayments, coinsurance, prescription coverage and family needs can all affect the real cost and usefulness of a health insurance plan.
Trinity can help you organize those questions and look at coverage in the context of how you and your household actually use healthcare.
Health Coverage
Built around real healthcare needs.
Marketplace Coverage
Core health benefits built into Marketplace plans.
Health Insurance Marketplace plans include ten essential health benefit categories. The exact services and plan details can vary.
01
Outpatient care
02
Emergency services
03
Hospitalization
04
Maternity & newborn care
05
Mental health & substance use services
06
Prescription drugs
07
Rehabilitative & habilitative services
08
Laboratory services
09
Preventive & wellness services
10
Pediatric services
Plan & Network Types
How you access care can change by plan.
Network rules affect where you can receive care, whether referrals may be needed, and how a plan handles out-of-network providers.
HMO Plans
Health Maintenance Organization
HMO plans generally focus coverage on doctors, hospitals and providers within the plan's network, except for emergency care.
- Network-based care.
- Out-of-network care is generally limited except for emergencies.
- Plan rules can include coordinated primary care.
PPO Plans
Preferred Provider Organization
PPO plans generally allow members to use both in-network and out-of-network providers, although out-of-network care can cost more.
- Lower costs are generally available within the plan network.
- Out-of-network care may be available at a higher cost.
- Specialist referrals generally are not required.
EPO Plans
Exclusive Provider Organization
EPO coverage generally requires members to use doctors, specialists and hospitals inside the plan network except in an emergency.
- Network-focused plan structure.
- Out-of-network services are generally not covered except emergencies.
- Confirm providers before choosing a plan.
POS Plans
Point of Service
POS plans generally cost less when members use providers inside the plan network and may require referrals from a primary care doctor for specialists.
- Network care generally costs less.
- Specialist referrals may be required.
- Provider rules should be checked before enrollment.
Details That Matter
Check the things you use most.
A plan can look good on paper and still be a poor fit if your doctors or medications do not work well with its network and coverage rules.
Prescription Coverage
Review your medications.
Check whether your prescriptions are covered, how they are placed within the plan's drug list, and what pharmacy options are available.
Cost Structure
Look at the total cost.
Monthly premium is only one part of health coverage. Deductibles, copayments, coinsurance and other out-of-pocket costs can also affect your budget.
01
Annual Open Enrollment
The Health Insurance Marketplace has an annual Open Enrollment period when eligible consumers can enroll in or change Marketplace health plans.
02
Special Enrollment Periods
Certain life events may make you eligible for a Special Enrollment Period outside annual Open Enrollment.
03
Changing Household Needs
Income, household size, location and current insurance can affect eligibility, plan availability and potential savings.
The Trinity Approach
Start with your healthcare needs, then compare the plan details.
How Trinity Can Help
Make the health insurance conversation easier.
Trinity can help you organize the factors that matter when considering health insurance and discuss coverage based on your household, healthcare use and available options.
01
Tell us who needs coverage
Start with the individual or family members who need health insurance.
02
Review healthcare priorities
Consider doctors, medications, routine care and expected healthcare.
03
Compare available plans
Review applicable costs, networks, coverage and plan rules.
04
Choose your coverage
Select coverage based on the plan details and needs that matter to you.
Consider the deductible, copayments, coinsurance, out-of-pocket limits, provider network, prescription coverage and services you expect to use.
A provider network is the group of doctors, hospitals and other healthcare providers that have arrangements with the health plan. How out-of-network care is handled depends on the plan type.
Bronze, Silver, Gold and Platinum are Marketplace plan categories that describe how costs are shared between you and the plan. They do not indicate the quality of medical care.
You may qualify for a Special Enrollment Period after certain life events, such as losing qualifying coverage, getting married, having or adopting a child, or certain changes in residence.
Trinity can discuss your health insurance needs and help you review coverage options available through the agency based on your situation and eligibility.
Health Insurance Marketplace information
Visit HealthCare.gov →
Marketplace rules, eligibility, plan availability, enrollment periods, benefits and costs can change. Trinity Life, Health & Financial Services is an insurance business and is not HealthCare.gov or a federal government agency.
Health Insurance Guidance
Ready to find health coverage that fits your needs?
Start with your household, doctors, prescriptions and budget. Trinity can help you work through the coverage conversation.