Top Healthcare and Insurance Insights All in One Place

Health insurance plans are grouped into metal tiers. Each metal tier represents how you and your insurance provider will split the costs of medical care. At the end of the day, selecting the right one comes down to which one works the best for you.

What to know before picking a precious metal

Before you start shopping for health insurance plans, go through this quick checklist:

1. Review how much you’ll make this year

Those with a tight estimated yearly household budget may qualify for state-sponsored subsidies to help make your medical expenses more affordable. For example, If you’re between 100% and 250% of the federal poverty level and choose only a Silver plan, you may qualify for additional tax subsidies to help reduce out-of-pocket costs like deductibles, copays, coinsurance, and annual maximums in addition to receiving premium tax credits.

2. Think about how much care you expect to use

Consider your age, health condition, and prescription medication needs. If you know you’ll be visiting the doctor often, springing for a more expensive plan is likely worth it.

3. Read up

Learn about how insurance plans work, including the differences between premiums, deductibles and copays.

4. Consider which providers you can’t live without

Make sure the insurance network you go with covers them. HealthBird makes this part a breeze.

Bronze, silver, gold or platinum? What’s the difference?

Most health insurance companies offer plans structured in metal tiers, from bronze to platinum. The more valuable the metal, the more coverage is included. The percentage of total average costs for covered benefits is known as the plan's actuarial value. If a plan advertises an actuarial value of 80%, for example, you’d be responsible for paying an average of 20% of all covered benefits.

The figures aren’t exact, varying from year to year depending on which services you use, but it provides a solid estimate of how much you can expect to pay for care. Typically, policies are structured with the following coverage:

• Platinum plans: 90% coverage, you pay 10%
• Gold plans: 80% coverage, you pay 20%
• Silver plans: 70% coverage, you pay 30%
• Bronze plans: 60% coverage, you pay 40%
• Catastrophic plans: Similar to a bronze plan, only with even lower premiums

Different insurance companies may offer slightly different percentages in each tier, but you get the idea. Just read the details of any plans you’re considering to see the exact breakdown. Keep in mind that metal tiers do not relate to the quality of care, but the cost of care. You’ll get the same care with a silver plan as with a platinum plan– You’ll just pay more out of pocket.

If a platinum plan offers the most coverage, why doesn’t everyone choose it?

Plans in higher metal tiers offer better coverage, but they also cost more per month. The monthly premium of a Gold plan is higher than that of a Bronze plan, but you’ll pay less at the doctor’s office when that pesky cold turns into a nagging sinus infection. The most expensive plan isn’t always the best fit, however. There’s nothing wrong with choosing a lower-tier plan with a lower monthly premium, as long as you plan ahead for higher medical expenses when you do need care.

Silver plans are known as the “benchmark” option because of their moderate monthly premiums and moderate costs when you need care. If you want to qualify for cost-sharing reductions, like reduced deductibles, copays, and coinsurance, you must choose a silver plan.

In a pinch, a catastrophic health plan is way better than nothing

Way, way better. Trust us. Catastrophic health insurance plans, also known as minimum coverage plans, are like the secret fifth option outside of the traditional tier system. They’re designed to protect young people in good health from worst-case health scenarios. They have the lowest premiums of all, and they have bare-bones coverage, but they’ll keep you from getting crushed by an avalanche of medical debt if you get seriously ill.

The exact coverage varies from state to state, but a common coverage breakdown looks something like this:

• Three no-cost doctor or urgent care visits
• Free preventative care
• No additional covered services until you spend thousands out of pocket, after which all in-network services are covered at 100%. The deductible varies from plan to plan, but most catastrophic plans require you to spend at least $5,000 before services are covered

These plans are usually available for people under the age of 30, but if you’re 30 or over, you can buy catastrophic coverage if you have a state-approved exemption. That said, it might be better to consider a bronze plan instead. The premium of a bronze plan is often similar to that of catastrophic coverage, and your deductible is usually lower with a bronze plan. You might also qualify for a cost reduction on a Bronze plan if you meet certain income requirements, while no discounts are offered for catastrophic plans.

What are the costs of each health plan?

Any plan you choose will have a monthly premium. Thanks to the American Rescue Plan Act of 2021 and the Inflation Reduction Act of 2022, monthly payments will reach record affordability this coming year. New financial assistance with premiums means that 4 out of 5 people will be able to find a plan for $10 or less per month. Wow! If you qualify for a premium tax credit — also known as a premium subsidy — this financial assistance will reduce your monthly bill.

The total costs of each plan will depend on what kind of plan you choose and how much you access care. Your monthly premium for the coverage year remains the same unless you have a change known as a qualifying life event. Beyond your monthly premium, there are other out-of-pocket expenses including deductibles, copayments and coinsurance.  You can get all the details on the differences in our previous journal post.

Once you hit an annual limit, known as the out-of-pocket maximum, all covered services will be paid 100% by your insurance provider. This year’s marketplace plans, the out-of-pocket maximum is $9,100 for an individual and $18,200 for a family.

Not sure which plan to choose? It’s about to get a whole lot easier thanks to HealthBird

As a rule of thumb, if you use your health benefits frequently or have a pre-existing condition, springing for a higher-tier plan is worth it. If you only go for an annual physical unless you’re on the brink of death, a lower-tier plan may be a better match.

Step 1: Make a HealthBird account. It’ll only take a few minutes, we promise.

Step 2: Answer a few easy questions, and let our insurance search AI, Costa, do its magic. It’s like a virtual assistant available 24/7, and it’s free.

Step 3: Review your insurance quotes and weigh your options. You can always save your quotes for later if you need time to think them over.

Step 4: Reach out for help if you’re on the fence! Our concierge team is available seven days a week to point you in the right direction.

Step 5: Buy a plan, and get coverage this year. Plans starting as low as $0/month*. It’s that easy.

Step 6: Manage your coverage and care from your smartphone, all in the intuitive HealthBird app.

It’s that easy. To try out HealthBird, make an account in minutes, or contact us with questions.

** Individual exchange plans only if you qualify. Not an actual consumer quote. Premium rates vary based on state, income, and family size. Additionally, subsidies are subject to qualifications based on factors including but not limited to your state, household income, and household size. Policies have limitations and exclusions. Reflekt Technologies, Inc., DBA HealthBird, This website is operated by Reflekt Technologies, Inc. (DBA “HealthBird”); and insurance brokerage services are provided through Insurance Bird, LLC of Florida (“Insurance Bird”); NPN: 20422094

There are many things to love about living in the United States, but our healthcare system isn’t usually on the list. Health insurance is required by law, but enrolling in a health insurance plan in the States is both confusing and expensive. If you’re one of the millions of Americans who are frustrated and fed up, this one’s for you. The groundbreaking HealthBird platform (soon app too!) is officially up and running, marking the start of a new chapter in American healthcare.

What’s different about HealthBird, you ask? A lot.

The health insurance industry isn’t an easy one to change. There’s over 100 years of history at play. Completely reinventing American healthcare is a tall order, so the HealthBird team focused on making the system we have easier and more accessible. We started changes with the insurance search process, purchase and enrollment.

Up until now, signing up insurance has looked something like this:

Step 1: Find out through a Netflix ad that open enrollment is happening soon

Step 2: Google how to sign up for insurance

Step 3: End up on a disorganized, state-funded health insurance site and fill out a long list of questions

Step 4: Receive an even longer list of plan options

Step 5: Spend hours trying to figure out the difference between each one

Step 6: Give up, and either pick one at random, or go without insurance and hope you don’t get appendicitis

With HealthBird, things work like this instead:

Step 1: Learn ahead of time that open enrollment is coming soon

Step 2: Open app.healthbird.com  

Step 3: Answer a few questions on an intuitive platform

Step 4: Get a handful of customized quotes chosen just for you by our advanced algorithm Costa AI

Step 5: Pick the plan that you like the best. Enrolled!

Step 6: Use the platform  to access your insurance cards, track your prescriptions and get appointment reminders all in one place.

Bonus step: Add dental, vision and hearing coverage to your health insurance in one HealthBird account and rule them all!

Better, huh? You’ll still have access to just as many plan options, only our innovative Costa AI will do all the comparing and sorting for you.

Our old system is so unnecessarily complicated that we need guides to navigate it. HealthBird makes it so much easier to make informed decisions about your own health. Taking care of your health should never be a headache. Our ultimate goal is to reformat old ways of thinking, so that no one ever has to dread signing up for insurance. Oh, and it’s only going to get better from here.

Over the course of the next year, HealthBird members can expect:

• Ongoing app development to continue improving our algorithm’s accuracy and speed
• The launch of a brand new product made just for families (Shhh! Don’t tell anyone!)
• The addition of other insurance plan options, like life insurance and pet insurance
• Even more available plans, in more areas of the United States

Ready to see HealthBird in action? Take it for a spin and enroll today.

Is there something we missed? Reshaping American healthcare is a community effort. If you have ideas for HealthBird features you’d like to see in the future, contact us here to share your feedback. We’d love to hear from you.

Everyone knows going without health insurance isn’t a great idea. (It’s also technically illegal, so there’s that.) So why does it have to be so insanely confusing? HMOs, PPOs, tier systems…what does this nonsense even mean? Is an insurance agent required? What’s an insurance marketplace? Do not feel bad if it seems overly complicated and confusing. We were confused too, so we put together the list below to break it down.

Before you start shopping, let’s clear up a few things

1. What the heck is a health insurance policy, anyway?‍

Simply put, a health insurance policy is a contract with a health insurance company. You promise to pay a certain monthly amount in exchange for payment or reimbursement for your health care expenses. Insurance usually covers some services in full, like annual health screenings. You’ll have to pay a portion of the cost of medication, tests, procedures, and specialist visits, but not nearly as much as the services would cost without insurance. For more details on plan types and what costs you can expect, check out our previous journal post covering just that.

2. What are health marketplaces?

Health marketplaces are state-based websites that provide insurance plan options based on your income and circumstances. If you sign up for insurance through Healthcare.gov or your state’s health insurance marketplace, you can find out whether you’re eligible for savings on your next plan.
Health insurance marketplaces aren’t a bad thing. The only downside of shopping for insurance on a traditional marketplace is that you’ll have to read the details of every plan in your price range to see if the coverage is enough for your needs. It can be an overwhelming experience for a non-professional: to weigh all pros & cons of each plan to make a final decision.

3. Why is buying directly from insurance companies a bad idea?

Buying insurance through a marketplace is called buying an “on-exchange” plan. An off-exchange plan is an option, but it’s not a very good one. This happens when you buy a plan directly from an insurance company, like Anthem Blue Cross or UnitedHealth. The benefits will be the same, but because it isn’t processed through a state-based marketplace, you might not receive any savings that you may be eligible for. This might mean to compare simultaneously dozens of plans directly on the insurance company’s website and on the marketplace. Just too much hustle.

4. Gold, silver, platinum…what does insurance have to do with metal? ‍

Nothing, really! The metal tiers are simply used to indicate how much coverage a health insurance policy offers. The more “expensive” the metal, the more coverage is included. A gold or platinum plan will pay a higher percentage of your medical expenses than a bronze or silver plan.

Each tier has pros and cons. If you plan on seeing lots of specialists, or if you have several medications that aren’t covered by cheaper plans, a gold or platinum plan is worth the extra expense. If you primarily use your insurance for wellness visits and emergencies, a lower tier plan may be just fine.‍

5. What is a health insurance quote?

Before you sign up for a policy, you’ll get to see a breakdown of what each plan offers and how much it will cost you. This is called a quote. You don’t have to commit to buying insurance to check your options, so compare at least a few before enrolling in a new policy.
Keep in mind: more isn’t always better. I mean, why would you pay for a Netflix family plan if you’re the only one watching, right? In case you go to the doctor frequently, then yes, a more expensive plan makes sense. You pay more upfront but will pay less for the services after. Cheaper plans equate to more financial risk if you do get sick, but for people who are young and healthy, the extra expense of pricier plans may not be worth it.

6. Is it easier to shop through an insurance agent?

The short answer: No. At first glance, it sounds like a dream. You talk to a real person, and they tell you exactly what plan you should sign up for. They even handle the signup process for you. What’s the problem? Well, insurance agents don’t work for free. They’re paid a commission by health insurance companies, so they’re likely to push you towards options that will land them a bigger check. Even if it’s a more expensive policy than you need. Hard pass. They also don’t represent every insurance company, so you may miss out on an amazing plan just because your insurance agent doesn’t offer it.

7. Where should you purchase a health insurance policy?

Well, let’s look at the options. With an insurance marketplace, you’re eligible for savings, but you also have to sort through all the plans on your own. That takes time. An agent will save you time, but you’ll likely end up spending more money. Then, you have HealthBird. Think of us as your unbiased assistant. We’re like an insurance marketplace that helps narrow down your options for free. You call the final shots; we just do some of the heavy-lifting.

How HealthBird makes it so much easier to shop, buy, and track your health coverage

HealthBird doesn’t make decisions for you. Our game-changing Costa AI is designed to assess your needs and sort through available plans for you. It saves tons of time, and with no additional cost. Our Costa AI can:

• Analyze over 100 health insurance plans from the 18 states HealthBird currently covers, saving hours of research time*.
• Eliminate the bias of human insurance agents, who love to upsell customers on plans they don’t really need
• Offer instant quotes to compare. Need more time to think over your options? No worries. You can come back later to review your quotes, and the rates won’t change a bit.
• Ask questions that actually matter. For example, Costa takes into account parameters that are important to you, like the number of doctor visits you usually need each year, or which medications you take. We analyze not one, not two, but 16 different parameters to help you find the perfect plan. Guess how many parameters healthcare.gov considers? Six. If their site challenged us to a fight, we’d stand down, because it just wouldn’t be fair.
• Simplify the entire enrollment process. When you pick a plan, you’ll fill out your information one time. That’s it. No more paperwork. (We hate paperwork, so this is our favorite feature.)
• Make your insurance shopping experience easy and fun. The seamless, modern app design is intuitive and easy enough for your 90-year-old grandpa to use.

What’s the catch? Oh wait, there isn’t one.

HealthBird is like the Match.com of health insurance shopping, minus the awkward first dates. (Plus, we’ll never ghost you!) Instead of getting a policy that gets an agent the biggest check, or wasting hours staring at confusing insurance jargon before giving up and picking a random plan just to be done with it, you’ll get a policy you’ll actually use, for a price you can afford.

Questions? We’re all about helping our members make educated choices about their health, so feel free to reach out if you need additional help via our social media channels or Live chat on the website.. We’ve been there!

*Based on the area code the number of insurance plans analyzed for a certain filter may vary.