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What is the difference between bronze, silver, gold and platinum health plans?

The short answer

Bronze, silver, gold and platinum describe how you and the plan split the cost of covered care. On average a bronze plan pays 60%, silver 70%, gold 80% and platinum 90%. Lower-paying plans have lower monthly premiums but higher costs when you use care. The level says nothing about the quality of care.

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How do the four levels compare?

LevelPlan pays on averagePremiumDeductible and copaysGood to know
BronzeAbout 60%LowestHighestLowest premium of the four main levels.
SilverAbout 70%ModerateIn betweenThe only level that can come with extra cost-sharing savings.
GoldAbout 80%HigherLowerCosts more each month, less when you get care.
PlatinumAbout 90%HighestLowestNot offered in every area.

These percentages are averages across all people on a plan, not what you will pay on a single bill. Your own costs depend on how much care you use and on the plan's deductible, copays and coinsurance.

What is a catastrophic plan?

Catastrophic plans are a fifth category. They are available to people under 30 and to people who qualify for a hardship or affordability exemption. They have low premiums and very high deductibles, and they mainly protect you from a large unexpected bill.

Why do many people choose silver?

If your income is low enough, silver is the only level where you can get cost-sharing reductions, which lower your deductible, copays and coinsurance. These reductions are for incomes roughly between 100% and 250% of the federal poverty level. Premium tax credits are also calculated from the benchmark silver plan in your area, although you can apply the credit to any metal level.

How should I choose a level?

Think about how much care you expect to use, how much you could pay at once if you had a surprise bill and how much you want to pay every month. Every marketplace plan has a yearly out-of-pocket maximum, which is capped by law at $12,000 for one person and $24,000 for a family in 2027. Check the network and the covered drugs too, because a cheap plan that does not include your doctor can cost more.

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Common questions

Does a gold plan give better care than a bronze plan?

No. The metal level only shows how costs are shared between you and the plan. The quality of care does not change.

Which metal level has the lowest monthly premium?

Bronze usually has the lowest premium among the four main levels, and the highest deductible. Catastrophic plans can be lower still but are only available to some people.

Can I get savings on any metal level?

Premium tax credits can be used on any metal level. Extra cost-sharing reductions are only available on silver plans.

Sources

Rules change. Confirm dates and eligibility with your marketplace, your state Medicaid agency or Medicare before you enroll.

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