Metal Tiers

Metal Tiers: Bronze, Silver, Gold, and Platinum​

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When the Affordable Care Act was passed, it established metal tiers to make it easier for consumers to compare qualified health plans across insurance companies.

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These four coverage levels through Covered California (also known as Obamacare) are sometimes called "metal plans" because of their names: Bronze, Silver, Gold, and Platinum.

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What does each tier cover?

To be approved as a qualified health plan in a particular metal tier, the plan must cover a certain different percentage of your health care costs overall. This is sometimes called the plan's “actuarial value.” Here's how much of your care plans in each metal tier will pay:

• Bronze plans: 60%

• Silver plans: 70%

• Gold plans: 80%

• Platinum plans: 90%

 

Since Bronze plans pay 60% of your care and you pay the other 40%, they cost less on a monthly basis than Gold and Platinum plans. Gold and Platinum plans have higher premiums, but they pay for more of your care if you're sick.

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Silver plans are special because a form of financial aid called a cost-sharing reduction (or CSR) can only apply to Silver plans. That means if you qualify based on your income, you are eligible for Enhanced Silver Plan options.

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Are there any other marketplace options available?

If you qualify, you may be able to sign up for a catastrophic plan. This type of plan is best only if you want to cover worst-case scenarios since it has a very high deductible but the lowest premiums. Catastrophic plans are only available to people under 30, as well as people of any age who apply for and receive a hardship exemption from the requirement to have health insurance. When you sign up for health insurance on the marketplace, depending on your household size and income, you may qualify for Medi-Cal.

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How do I choose the right tier plan for me?

There are a number of factors you should take into consideration when choosing the health insurance plan that's right for you. Call our team of experts to help walk you through the process of selecting the right plan that best fit your needs such as doctor visits and prescription drugs.