Gold Plans

Gold plans are one of the four "metal" options established by the Affordable Care Act. These plans can make sense if you regularly need medical care.

Gold plans typically have higher monthly insurance premiums than Bronze and Silver plans, however, they do have lower out-of-pocket costs when using medical services. The plan pays for 80% of your medical expenses, while you would be responsible for the remaining 20%, along with your premium.

Although Gold plans have fairly higher premiums, as with all metal plans your monthly insurance rate can be reduced if you qualify for the Premium Tax Credit. The Premium Tax Credit is like a “discount” that is paid for by the government and applied directly to your monthly rate. Your eligibility depends on the state you live and your annual household income, which should be at or below 4x the Federal Poverty Line.

Remember that the only difference among plans is the amount you pay, not the quality of health care you receive. By law, all four plans must meet the Ten Essential Health Benefits, which includes a free wellness visit and preventative care.

Does it Make Sense to Enroll in a Gold Plan?

Only you can decide what type of plan is best for your individual or family needs. It is important to consider your current health, lifestyle, and medical risk factors. That said, it is always best to think in terms of the total cost of the plan, which is the monthly premium, plus your anticipated out-of-pocket costs when using the insurance.

A Gold plan could be the right choice if you:

Would rather pay a higher monthly premium if it means you will pay less out-of-pocket when visiting the doctor, going to the emergency room, or using other health care services.
Anticipate needing regular medical care;
Already take or anticipate needing to regularly take prescription medication;

Keep in mind that no matter which metal level you choose, under Obamacare, all plans have the same maximum out-of-pocket limits. These limits protect you financially, especially if you need a lot of medical care. For 2025, the annual limit is $8,550 for an individual, and $17,100 for a family, including deductibles. Gold plans pays for 80% percent of covered medical expenses before reaching the limit, and then 100% of all covered expenses after reaching the limit.

If you need to lower your out-of-pocket costs even further, consider a Platinum plan. If you do not think you will need much more than preventative medical care, and would like to lower your monthly rate, consider enrolling in a Silver or even Bronze plan.

To start comparing Gold plans, enter your zip code or call (866) 915-4203 to speak with an agent.

Speak to a Health Care Agent
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QuoteLab, LLC
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Los Angeles, CA 90017
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Texas-HealthPlans.com is operated by QuoteLab, LLC, which is an independent broker and is not a federal or state Marketplace website. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance on QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

This website does not provide information about specific Medicare plans, or enable visitors to obtain quotes, on this website. However, if you provide your information and consent, we will transfer your information to Medicare Advantage organizations and/or their third party marketing organizations (TPMOs) that may contact you to offer Medicare Advantage and/or Part D plans, and we will receive compensation for such transfer. The advertisements appearing on this website are placed by clients from which QuoteLab, LLC receives compensation, and such compensation may impact whether such advertisements appear on this website and the order in which they appear.

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Federal Contracting Statement: The Medicare plans represented are PDP, HMO, D-SNP, PPO or PFFS plans with a Medicare contract. Enrollment in plans depends on contract renewal. No Obligation to enroll.

TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent [73] organizations which offer [5110] products in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Please note that these numbers provided are not specific to your area but rather represent the number of organizations and the number of products available on a national basis. We will connect you with licensed insurance agents who can provide information about the number of organizations they represent and the number of products they offer in your service area.

Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. QuoteLab, LLC is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on Texas-HealthPlans.com are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

Enrollment in a plan may be limited to certain times of the year unless you qualify for a special [election/enrollment] period or you are in your Medicare Initial Election Period.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

Texas-HealthPlans.com is operated by QuoteLab, LLC, which is an independent broker and is not a federal or state insurance Marketplace or other website. It does not provide access to any federal or state marketplace or exchange. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance are made through QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

This website does not provide information about specific health plans, or enable visitors to obtain insurance quotes, on this website. However, if you provide your information and consent, we will transfer your information to insurance carriers and brokers that may contact you to offer Affordable Care Act (ACA) plans, short-term plans, medical indemnity plans and/or healthcare sharing ministry plans, and we will receive compensation for such transfer. The advertisements appearing on this website are placed by clients from which QuoteLab, LLC receives compensation, and such compensation may impact whether such advertisements appear on this website and the order in which they appear.

Texas-HealthPlans.com is required to comply with all applicable federal law, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website does not provide a complete listing of, or display all data on all Qualified Health Plans being offered in your state or service area through the Marketplace website or the federal Medicare program. To see all available data on Qualified Health Plan options in your state, visit your state Marketplace website, go to the Health Insurance Marketplace website at https://www.healthcare.gov.

Note that even with a $0 premium Medicare Advantage plan, you'll still pay a monthly premium for Part B, and a Part D premium if your Medicare Advantage plan does not include prescription drug coverage (MA-PD).

Allowance Disclaimer: Allowance amounts cannot be combined with other benefit allowances. Limitations and restrictions may apply.

** Members may receive a monthly or quarterly allowance in the form of a benefits prepaid card to pay for a wide range of approved groceries and utilities. Unused amounts will expire at the end of the month or quarter.

*For [Humana] and [Molina], some benefits mentioned may be part of a special supplemental program for the chronically ill. Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

¹Transportation services are issued as one-way trips and provided on an annual basis. Benefits vary by plan.