Plans in the Marketplace are presented in 4 health plan categories: Bronze, Silver, Gold, and Platinum. (“Catastrophic” plans are also available to some people.)
FYI Health plan categories are based on how you and your plan split the costs of your health care. They have nothing to do with quality of care.
How you and your insurance plan split costs
Estimated averages for a typical population. Your costs will vary.
|Plan Category||The insurance company pays||You pay|
Which health plan category is right for you?
- Lowest monthly premium
- Highest costs when you need care
- Bronze plan deductibles — the amount of medical costs you pay yourself before your insurance plan starts to pay — can be thousands of dollars a year.
- Good choice if: You want a low-cost way to protect yourself from worst-case medical scenarios, like serious sickness or injury. Your monthly premium will be low, but you’ll have to pay for most routine care yourself.
- Moderate monthly premium
- Moderate costs when you need care
- Silver deductibles — the costs you pay yourself before your plan pays anything — are usually lower than those of Bronze plans.
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Getting extra savings with a Silver plan
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- If you qualify for cost-sharing reductions: You must pick a Silver plan to get the extra savings. You can save hundreds or even thousands of dollars per year if you go to the doctor a lot. (Silver plans may also be available if you’re eligible for a premium tax credit and can enroll through a Special Enrollment Period based on estimated household income.)
- If you’re enrolled in a Silver plan and lose your cost-sharing reductions: You’ll qualify for a Special Enrollment Period. If you want to change plans, you can enroll in a Bronze, Silver or Gold plan that meets your needs and fits your budget.
- Good choice if: You qualify for “extra savings” — or, if not, if you’re willing to pay a slightly higher monthly premium than Bronze to have more of your routine care covered.
- High monthly premium
- Low costs when you need care
- Deductibles — the amount of medical costs you pay yourself before your plan pays — are usually low.
- Good choice if: You’re willing to pay more each month to have more costs covered when you get medical treatment. If you use a lot of care, a Gold plan could be a good value.
- Highest monthly premium
- Lowest costs when you get care
- Deductibles are very low, meaning your plan starts paying its share earlier than for other categories of plans.
- Good choice if: You usually use a lot of care and are willing to pay a high monthly premium, knowing nearly all other costs will be covered.
Find out how to use total costs of care to pick a category and plan that work for you.
Note: Plans in all categories provide free preventive care, and some offer selected free or discounted services before you meet your deductible.
Your premium can be lower, based on your income
No matter which health plan category you choose, you can save a lot of money on your monthly premium based on your income.
When you fill out a Marketplace insurance application, you’ll find out if you qualify for these savings. Learn how you can save on your monthly insurance bill with a premium tax credit.
You can do a quick check now to see if your income’s in the range to qualify.