Metal Plan Coverage
Learn how to pick the right health insurance plan for your needs and budget.
Plan Categories (The "Metal" Categories)
Plans in the Marketplace are presented in 4 "metal" categories: Bronze, Silver, Gold, and Platinum. These categories show how you and your plan share costs. They have nothing to do with quality of care.
Catastrophic Plan
Very low monthly premium, covers essential health benefits after you meet a very high deductible. Designed for worst-case scenarios.
Eligibility Requirements:
- • Must be under 30 years old, OR
- • Have a hardship exemption or affordability exemption
Note: You cannot use premium tax credits with catastrophic plans. Best for healthy young adults who want protection against worst-case scenarios.
Need help choosing the right plan? Speak with one of our certified Marketplace agents who can guide you through your options.
Bronze
Monthly Premium: Lowest
Care Costs: Highest
Lowest monthly premium, highest costs when you get care.
Actuarial Value:
The plan pays 60% of covered medical expenses on average; you pay 40%.
Silver
Monthly Premium: Moderate
Care Costs: Moderate
Moderate monthly premium, moderate costs when you get care.
Actuarial Value:
The plan pays 70% of covered medical expenses on average; you pay 30%.
Gold
Monthly Premium: High
Care Costs: Low
High monthly premium, low costs when you get care.
Actuarial Value:
The plan pays 80% of covered medical expenses on average; you pay 20%.
Platinum
Monthly Premium: Highest
Care Costs: Lowest
Highest monthly premium, lowest costs when you get care.
Actuarial Value:
The plan pays 90% of covered medical expenses on average; you pay 10%.
💡 Helpful Hint: Cost-Sharing Reductions (CSR)
If your household income is between 100% and 250% of the Federal Poverty Level, you may qualify for Cost-Sharing Reductions - extra savings that lower your out-of-pocket costs when you get care.
CSRs are ONLY available with Silver plans and can:
- ✓Lower your deductibles (the amount you pay before insurance kicks in)
- ✓Reduce your copayments and coinsurance (what you pay at each visit)
- ✓Lower your out-of-pocket maximum (the most you'd pay in a year)
Important: Even if a Gold or Platinum plan seems better, Silver plans with CSRs often provide the best value for eligible individuals and families. Speak with a licensed agent to see if you qualify!
Important: All metal tier plans cover the same essential health benefits. The difference is only in how costs are shared between you and the insurance company.