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Compare health plan currencies to ensure smart investment.

So you want to get health care coverage through the Affordable Care Act before the Jan. 31 deadline?

Head to the marketplace to research and compare health plans. These choices will affect both your costs and coverage so it’s important to comparison shop.

All plans offered in the marketplace cover the same 10 essential health benefits: ambulatory patient services; emergency services; hospitalization; pregnancy, maternity and newborn care; mental health and substance use disorder services; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

While each plan covers these services, the amount you pay versus how much your insurance provider pays will vary based on the plan tier you select.

The first step in picking a plan is to determine if you qualify for financial assistance.

“All marketplaces have a subsidy calculator. Put in your income and household size to see if you are eligible for financial assistance,” says Karen Pollitz of the Kaiser Family Foundation.

Then, go to the marketplace, where most people will be pleasantly surprised by what they find.

“Rate increases were very conservative this year,” says Elizabeth Benjamin, vice president of health initiatives at Community Service Society of New York.

Premiums, which surged last year, have gone down in some cases.

“Generally, the news is good. If you were eligible for premium or tax credits last year then you will probably pay the same this year. Some insurance companies who left the Marketplace have come back in for 2019 so people may get more choices,” Pollitz says.

The next step in the process is selecting a category of coverage within the four metal tiers: bronze, silver, gold and platinum. The difference between tiers is the cost split between what the beneficiary pays versus what the insurance company pays. These costs include the monthly premium, annual deductible and out-of-pocket expenses such as co-payments and prescriptions.

For bronze plans, which feature the lowest premiums, the beneficiary pays 40% of health care costs and the insurance company 60%. In New York State, bronze plans will be free to individuals with incomes up to $25,000 and not eligible for Medicaid or the Essential Plan in every county of the state, and less than $50 a month for individuals with incomes up to $30,000 a year in 41 counties.

Bronze plans provide no-cost preventive care and protect against catastrophic costs despite having a higher annual deductible than other available plans, according to NY State of Health.

Premiums increase as you move up the metal tier ladder, as do the percentages that consumers pay. In silver plans, the most popular choice among New Yorkers, consumers pay 30% of health care costs.

However, when comparing plans, look beyond the premiums, factor in any financial assistance you may be eligible for and compare the range of plans.

Plan information is available at