This refers to a specific health insurance plan. Characterized by a metallic tier designation and a numeric identifier, it combines elements of a managed care delivery system. It requires individuals to select a primary care physician within a network, coordinating their health care and often necessitating referrals for specialist visits. Benefits typically include coverage for preventive care, doctor visits, hospital stays, and prescription drugs after applicable cost-sharing requirements are met.
Such plans can offer a balance between premium costs and out-of-pocket expenses, making them attractive to individuals and families seeking affordable health coverage. The established network can lead to lower healthcare costs compared to plans that allow out-of-network care. These plans often emphasize preventive care, potentially leading to improved long-term health outcomes and reduced healthcare expenditures.
