Even when a service or medication is covered, you may pay part of the cost. Learn how out-of-pocket costs like copays, coinsurance and deductibles work. (Video, 2:41)Open video transcript
Value standards across health plans
Our qualified health plans are ranked using metal tiers: Bronze, Silver, Gold and Platinum. Metal tiers help you compare health plans with similar actuarial value – the amount of costs covered by the plan. All plans within each metal tier include a monthly premium (the amount you pay each month for your coverage) and out-of-pocket costs when you get care (copays, coinsurance and deductibles), but the amounts differ across metal tiers.
Each tier provides an average percentage of coverage:
- Bronze: 60 percent
- Silver: 70 percent
- Gold: 80 percent
- Platinum: 90 percent
Bronze health plans usually have the lowest premiums and highest out-of-pocket costs – copays, deductibles and coinsurance. Platinum plans typically have the highest premiums and lowest out-of-pocket costs.
It's impossible to predict all your health care needs for the year ahead. But we can help you choose a plan that fits your health insurance needs and budget.
- Platinum or Gold level plans may be a good idea if you make frequent doctor visits or need prescriptions on an ongoing basis.
- Silver plans cost a little less per month than platinum or gold plans and may be a better option if you don’t expect to use medical services or prescriptions very often.
- Bronze plans cost less per month in premiums but also pay less of your costs when you need care.