The Affordable Care Act established levels or tiers for health insurance plans so that buyers understand what their potential out-of-pocket costs may be and to provide comparisons. Medical Mutual offers Gold, Silver and Bronze plans.

Essential Health Benefits

No matter which plan you choose, certain “Essential Health Benefits” will be included, though they may be subject to copays and coinsurance:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance abuse disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (to age 19)

Gold Plans

Gold plans will typically cover about 80% of your healthcare costs.  Because gold plans cover such a large percentage they typically cost more.  However, if you intend to use medical services and can afford higher premiums, a gold plan may be a good choice.

Silver Plans

With a silver plan, your insurer will typically cover about 70% of your healthcare costs.  Premiums will generally be lower than those associated with a gold plan, but coverage will not be as comprehensive.

Bronze Plans

A bronze plan will cover about 60% of your healthcare costs.  While this is less than silver or bronze plans, premiums will generally be lower.  If you do not expect to use medical services frequently, but still want some coverage for larger, unplanned medical expenses, a bronze plan might be the right choice for you.

Medical Mutual Plans by Metal Tier

For 2017, Medical Mutual is offering plans in the following metal tiers:

Metal Tier  Plan Type  Available on the Health Insurance Marketplace at  Available on the Medical Mutual Marketplace? 
Gold  HMO Yes  No 
Gold  POS  No No 
Silver  HMO  Yes  Yes 
Silver  POS  No No 
Bronze  HMO Yes  Yes 
Bronze  POS  No  No

Ready to Shop?

You can also call us at 1-855-444-0162 or call your licensed insurance agent.