Commonly referred to as “metal levels,” the primary difference is the percent of expected costs the plan will cover!
Health plans are designed around the principle of cost sharing: Expensive plans cover a larger percentage of medical costs and lesser-priced plans cover a lower amount. These categories will not impact the quality of care that you receive!
In order to make it easier for consumers to compare plans, they are organized into four “metal” levels:
- Bronze-level plans cover 60% of expected costs for the average individual
- Silver-level plans cover 70% of expected costs for the average individual
- Gold-level plans cover 80% of expected costs for the average individual
- Platinum-level plans cover 90% of expected costs for the average individual
Bronze plans: Although your insurance is only covering 60% of the cost as compared to the 90% covered by Platinum, Bronze plans have low monthly premiums. If you stay healthy and use insurance infrequently, you will likely save money on this type of plan.
- These plans are great for a young healthy person that doesn't visit the doctor for more than the yearly checkup. The premiums will be the lowest, but you might have to pay a little bit more out of pocket for regular visits. However, you'll have financial protection against a major accident or an expensive hospital stay!
Silver plans: Silver plans are similar to Bronze plans. They charge slightly higher premiums for coverage that kicks in sooner (meaning, this plan usually has a lower deductible too).
- Silver plans are often a good value for people who see the doctor from time to time and take a common medication or two.
- Silver plans are the only plans that can have extra savings known as cost-sharing reductions. If your modified adjusted gross income is under 250% of the Federal Poverty Level, your Silver Plan options will be eligible for these savings!
Gold plans: These plans provide a lot of assistance in paying for more medical expenses in exchange for a higher monthly premium. Many have very low deductibles -- sometimes as low as $0, which means coinsurance kicks in immediately on your first care of the year.
- Gold Plans are great if you expect to have large or frequent medical expenses or if you want the peace of mind of knowing the majority of your expenses will be covered.
- Gold plan levels and up are the ideal plan for pregnant women.
Platinum plans: These premium plans are typically for people who have ongoing health conditions that will require regular visits to doctors and specialists or special medical equipment and treatments. These are also great plans for those who want the peace of mind that comes with knowing you will have almost negligible out-of-pocket medical expenses throughout the year.
- Platinum plans have the highest monthly premiums, but the most generous benefits. Many have $0 deductibles so you'll never pay more than 10% of your medical bill after the plan start date.
In summary, Bronze plans will have lower premiums (your monthly insurance bill) with higher deductibles and out-of-pocket costs. On the other end of the spectrum, Platinum plans will have higher premiums, but with lower deductibles and out-of-pocket costs. Silver and Gold plans toe the line between these two metal levels.
Check out our handy insurance guide here if you want to know more about health insurance!