Why do metal levels matter when shopping for a Marketplace plan?

Choosing the best metal level (bronze, silver, gold, or platinum) is critical when it comes to health insurance benefits and savings. Metal levels directly impact your total health care costs throughout the year. To understand what all of this means, let’s go over the difference between a Bronze, Silver, Gold, and Platinum plan:

Bronze

Bronze plans tend to have the lowest monthly premiums but higher costs when you need care. Bronze plans must cover an average of 60% of all your covered out-of-pocket costs. While you are responsible for the remaining 40%. They also qualify for tax credits or a subsidy.

Silver

Silver plans tend to have the second lowest monthly premiums and have moderate costs when you need care. Silver plans must cover an average of 70% of all your covered out-of-pocket costs. While you are responsible for the remaining 30%. They also qualify for both tax credits and extra savings also known as cost-sharing reductions. These are the only types of plans to qualify for cost-sharing reduction (we’ll get to that in a minute).

Gold

Gold plans tend to have the second highest monthly premiums but lower costs when you need care. Gold plans must cover an average of 80% of all your covered out-of-pocket costs. While you are responsible for the remaining 20%. They also qualify for tax credits.

Platinum

Platinum plans tend to have the highest monthly premiums but the lowest costs when you need care. Platinum plans must cover an average of 90% of all your covered out-of-pocket costs. While you are responsible for the remaining 10%. They also qualify for tax credits.

What is a catastrophic health plan?

There are also Catastrophic health plans which have the lowest monthly premiums but extremely high deductibles This type of plan can be an affordable way to protect yourself from unexpected worst-case scenarios, like getting seriously injured or sick. These plans also count as minimum essential coverage (which means you will avoid the “Individual Shared Responsibility Payment” also known as the individual mandate fine or ACA penalty). If you are under 30 or obtained a “hardship exemption” you would qualify to enroll in this type of plan.

How do subsidies and cost-sharing reduction effect metal levels?

You also may qualify for support to help lower your healthcare costs, including a subsidy or cost-sharing reduction (CSR). A subsidy is a type of financial assistance, and if eligible will reduce your monthly payment (or premium) as soon as your coverage begins. And cost-sharing reductions provide a discount that lowers the amount you have to pay for deductibles, coinsurance, and copayments. This is based on your income and can only be applied to Silver plans.

Now that you have a better understanding of the different types of plans, your decision should be a little easier to make. If you still have some questions – or need help choosing which metal level is right for you, reach out to our Consumer Advocate team for help: (855) 772-2663.

HealthSherpa

HealthSherpa is a free website and team of real people who can help you find, enroll in, and make the best use of your marketplace health insurance.