Metal

 

plans

 

Understanding metal plans

Bronze, silver, gold and platinum – which plan is right for you?

Effective January 1, 2014, four tiers of health insurance will be offered to those who shop in the individual and small group Marketplace. These tiers are known as “metal levels” – bronze, silver, gold and platinum – and they define health insurance value.

Generally speaking, the gold and platinum plans will offer more comprehensive coverage at a higher premium than a bronze or silver plan. Shopping by metal level allows you to compare plans with similar levels of coverage and cost sharing based on premiums, provider networks and other factors. The health reform law will cap the annual amount of cost sharing for covered services you are responsible for.

The metal level equates to the actuarial value (AV). Actuarial value is the percentage that each health insurance plan will have to pay of the total allowed essential health benefits. AV is the percentage of total average costs for covered benefits that a plan will cover. You are responsible for the remaining percentage.

  • Bronze health plans: 60% AV
  • Silver health plans: 70% AV
  • Gold health plans: 80% AV
  • Platinum health plans: 90% AV
  Health Care Reform Understanding Metals

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Information on this website is based on sources from Kaiser Family Foundation, the Federal Register, Congressional Research Service, Healthcare.gov, Whitehouse.gov and USChamber.com.