Get Coverage How to choose a plan

The 'metal' categories: Bronze, Silver, Gold & Platinum

Plans in the Health Insurance Marketplace are presented in 4 "metal” categories: Bronze, Silver, Gold, and Platinum. (“Catastrophic” plans are also available to some people.)

FYI Metal categories are based on how you and your plan split the costs of your health care. They have nothing to do with quality of care.

How you and your insurance plan split costs, for each metal category

Below are estimated averages for a typical population. Your actual expenses will vary.

How you and your plan share total costs of care

Plan Category The insurance company pays You pay
Bronze 60% 40%
Silver 70% 30%
Gold 80% 20%
Platinum 90% 10%

How to use these categories to pick a plan

  • Generally, plans in the Bronze category have the lowest premiums (your monthly insurance bill) but the highest deductibles and other out-of-pocket costs.
  • Platinum plans generally have the highest premiums but the lowest deductibles and other out-of-pocket costs.
  • If you qualify for cost-sharing reductions based on your income and enroll in a Silver plan, you can get the best of both worlds: A fairly low premium, plus a lower deductible and other out-of-pocket costs. Your “total costs of care” include your premium, your deductible, and other out-of-pocket costs. Find out how to use total costs of care to pick a category and plan that work for you.

Your monthly premium can be a lot lower based on your income

No matter which metal category you choose, you can save a lot of money on your monthly premium based on your income.

When you fill out a Marketplace insurance application, you’ll find out if you qualify for these savings. Learn how you can save on your monthly insurance bill with a premium tax credit.

You can do a quick check now to see if your income’s in the range to qualify.

Catastrophic health insurance plans

Catastrophic health insurance plans have low monthly premiums and a very high deductible — $6,850. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. You pay most routine medical expenses yourself.

See details about Catastrophic health plans

Monthly premiums are usually low, but you can’t use a premium tax credit to reduce your monthly cost for a Catastrophic plan. If you qualify for a premium tax credit based on your income, either a Bronze or Silver plan could be a better value. Be sure to compare.

Catastrophic plans cover less than 60% of your total costs of care. You pay more than 40%.

Only people under 30 and people of any age with a hardship exemption from the requirement to have health insurance.

Catastrophic plans cover 3 primary care visits per year, and certain preventive services, at no cost. You have to pay all other medical costs yourself until you reach your deductible –$6,850 in 2016. After that, the plan pays 100% of covered services. If you’re eligible to buy a Catastrophic plan, you’ll see them displayed when you apply and compare plans in the Marketplace.

 
 

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