If the Marketplace is like a big online shopping mall for health insurance, then metal levels would be the different departments within the mall.
Metal levels are the four categories of coverage available in insurance plans bought through the Marketplace. They were put in place by the Affordable Care Act to regular costs across health insurance plans. So no matter what plan you choose, it’ll either be a Bronze, Silver, Gold, or Platinum plan.
The names are misleading, though, because it’s not like Platinum is the best plan and Bronze is the worst plan. A plan’s level is determined by the amount of value they provide you, the consumer. Here’s a quick overview of what the metal levels mean for you:
Bronze plans- Health plan pays 60% of medical bill, you pay 40%. Out-of-pocket costs are the highest but have the lowest monthly costs.
Silver plans- Health plan pays 70% of medical bill, you pay 30%. The most common choice because their costs fall in the middle compared to the other plans. Silver plans are also eligible for discounts.
Gold plans- Health plan pays 80% of medical bill, you pay 20%. They have high premiums, meaning that you’ll have less out-of-pocket costs in the form of deductibles, copays, and coinsurance. Gold plans also qualify for tax credits and discounts.
Platinum plans- Health plan pays 90% of medical bill, you pay 10%. Out-of-pocket costs are the lowest but have the highest monthly costs.
Keep in mind that these percentages aren’t always that clear cut. You might pay more or less for a service. It all depends on what’s detailed in your insurance terms. And you don’t want to choose a plan based on these percentages alone.
Think about it. If you purchased a Platinum plan and never used it, that would be a huge waste of money. And if you purchased a Bronze plan knowing that you have extensive procedures coming up, you would most likely be paying more than you should. You need to take your healthcare needs and wants into consideration.
For single 20-somethings
Most single 20-somethings will sign up for a lower monthly premium plan with a higher deductible, like a Bronze or Minimum Coverage plan. Why? Because, unless you really need to, you're not going to go visit the doctor. But this also means that you can stay healthy at a low cost and avoid bankruptcy if a medical catastrophe does occur.
A Bronze plan would be a good choice for a healthy family whose members are a little older. A Silver plan would be a good choice for a family that frequently visits their doctor or specialist, especially if lab tests are involved.
For people who visit the hospital often
Gold and Platinum plans have the highest monthly costs, but you pay less out-of-pocket costs. That means that Gold and Platinum plans might be the most affordable option if you visit your doctor a lot and need a lot of healthcare coverage.
Let us know if this article was helpful either through Twitter (@impacthealthio) or by dropping a comment below. We’d love to hear from you and answer any questions you may have!