What is the difference between bronze, silver, gold and platinum plans?
The metal describes how costs are split, not the quality of care. And one level carries a benefit the others do not.
Metal levels describe how costs are divided between you and the plan across a typical population. They say nothing about quality of care, the doctors available, or how good the insurer is.
All four levels cover the same essential health benefits and none of them can deny you for a pre-existing condition.
The four levels
- Bronze. Lowest premium, highest deductible. The plan covers roughly 60 percent of costs across a typical population.
- Silver. Moderate premium, moderate deductible. Roughly 70 percent.
- Gold. Higher premium, lower deductible. Roughly 80 percent.
- Platinum. Highest premium, lowest deductible. Roughly 90 percent. Not always offered.
Those percentages describe the plan's share across everyone enrolled, not your personal share. Your own cost depends entirely on how much care you use.
Why silver is different
Cost sharing reductions are only available on silver plans. If your income falls in the eligible range, a silver plan's deductible, copays and out of pocket maximum are all reduced, sometimes to levels better than a gold plan. Choosing bronze to save premium forfeits this entirely. It is the most expensive common mistake in Marketplace shopping.
The premium tax credit is also calculated against the second lowest cost silver plan in your area, which is why silver sits at the center of the whole system.
Who each level suits
- Bronze: healthy, rarely see a doctor, want protection against a catastrophic year, and are not eligible for cost sharing reductions. Be sure you could cover the deductible if you had to.
- Silver: almost anyone eligible for cost sharing reductions, and a sensible default otherwise.
- Gold: regular prescriptions, ongoing conditions, frequent visits, or a planned procedure. Higher premium, much lower costs when you use care.
- Platinum: heavy expected utilization, where the premium is worth eliminating most cost sharing.
How to choose properly
- Find out whether you qualify for cost sharing reductions. If you do, start with silver.
- Estimate your expected care for the year, honestly.
- For each candidate plan, add twelve months of premium to the deductible. That is roughly your cost in a moderate year.
- Add twelve months of premium to the out of pocket maximum. That is your worst case.
- Check your doctors and your medications on each.
- Choose based on those numbers rather than on the metal name.
Catastrophic plans
There is a fifth category available to people under 30, and to some others with a hardship exemption. Very low premium, very high deductible, and no premium tax credit can be applied to it.
Because the credit cannot be used, a subsidized bronze or silver plan is often cheaper and much better. Check before assuming catastrophic is the budget option.
See how deductibles and maximums work.
Common follow-up questions
Is gold better care than bronze?
No. The metal level describes cost sharing, not quality. Both cover the same essential benefits, though the networks can differ.
Why do people say to pick silver?
Because cost sharing reductions apply only to silver plans. If you qualify for them, silver usually delivers the best overall value.
Can I change metal levels later?
Generally only during open enrollment or with a qualifying life event.
Want this looked at properly?
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