| Comparing Health Plan Categories | ||||
|---|---|---|---|---|
| Tier | Monthly Premium | Costs When You Need Care | Deductible | Good If |
| Bronze | Lowest | Highest | Can be thousands of dollars a year | 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 |
| Silver | Moderate | Moderate | Usually lower than those of Bronze plans | 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. |
| Gold | High | Low | Usually low | 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. |
| Platinum | Highest | Lowest | Very low | You usually use a lot of care and are willing to pay a high monthly premium, knowing nearly all other costs will be covered |
Features of the Bronze Health Plan
Bronze category health plans are the second most popular health plan category among those who select a Marketplace plan. For 2023, around one-third were predicted to choose Bronze health plans, according to research from the Kaiser Family Foundation.
Bronze plans offer the lowest monthly premium, which can be helpful if you’re on a budget. The average lowest-cost premium nationwide is $342, according to the Kaiser Family Foundation.
However, you’ll face the highest out-of-pocket costs if you need to see a doctor for routine or emergency care. Deductibles can be thousands of dollars per year, so you’ll pay more out of pocket before your plan starts covering your costs. Once you meet the deductible, you’ll still pay more for copays and coinsurance than other plans.
Bronze plans are an affordable method for protecting yourself from high medical bills that could lead to financial ruin and an excellent alternative to no insurance. Because you purchased a plan on the marketplace, you can also benefit from free preventive care and other essential health benefits.
Features of the Silver Health Plan
Silver category health plans are the most popular category among those who select a Marketplace plan. Around 54% of the population chose Silver Health Plans for 2023, according to the Kaiser Family Foundation research.
Silver plans feature higher monthly premiums than Bronze, with KFF reporting the average lowest-cost premium nationwide as $448 in 2023. But you’ll pay less out-of-pocket when you need to see a doctor. A Silver health plan deductible should be lower than a Bronze health plan deductible, too.
You must select a Silver plan if you qualify for cost-sharing reductions due to your household size and income. That’s because the cost-sharing reductions are only applicable to Silver plans.
Features of the Gold Health Plan
Very few people choose a Gold category health plan—likely because Gold health plans have a higher monthly premium compared to Bronze or Silver plans, with an average lowest-cost premium of $472. Only around 12% of the population choose Gold Health Plans, according to the Kaiser Family Foundation.
When you do need care, you’ll only pay an average of 20% out of pocket. This may be a good deal if you frequently see care providers or are concerned about ballooning out-of-pocket costs. You’ll also benefit from lower deductibles compared to lower-premium plans.
Features of the Platinum Health Plan
Like a credit card, a Platinum plan is the highest-tier plan available on the Marketplace. As a result, only around 1% of the population selects this plan category, according to the Kaiser Family Foundation.
You’ll pay the highest monthly premium, but only 10% of health care costs out of pocket. Platinum deductibles are also the lowest among all plans, so you’ll pay less before your plan starts paying its portion.
Platinum may be a good fit if you know you’ll frequently visit the doctor this year and understand your higher monthly premium is balanced by the knowledge that other costs are covered.
What Is the Cheapest Health Plan Category?
A Bronze plan category asks the average insured to pay 40% of costs, while the insurer pays 60%. This is the lowest plan split among the four health plan categories. However, you may find less-expensive options available depending on your situation. For example, you may pay less if you qualify for a catastrophic plan or cost-sharing reductions paired with a Silver plan.
Who Qualifies for a Catastrophic Health Plan?
There are 14 reasons for which someone may be granted a hardship exemption and qualify for catastrophic health insurance, including homelessness; having substantial property damage resulting from fire, flood, or other disaster; and filing for bankruptcy in the past three years.
What Are the Four Categories of Expenses a Health Care Policy Owner May Pay?
If you have any health care policy, your out-of-pocket expenses could include deductibles, copayments, coinsurance, and non-covered expenses. You will also pay a monthly premium for the plan.
The Bottom Line
In the U.S. health insurance Marketplace, plans are offered in four levels: Bronze, Silver, Gold and Platinum. Gold and Platinum plans pay higher premiums but have lower out-of-pocket costs, while Silver and Bronze plans lower premiums but have higher out-of-pocket costs. Catastrophic coverage is available for people under 30 or people of any age who qualify for a hardship exemption.
Understanding the different health plan categories can help you choose a plan in line with your healthcare needs and budget. If you need help choosing a plan, a licensed health insurance broker or certified state assister can help you find the right option for you.