The Affordable Care Act has made it easier to understand health insurance by creating five rankings for individual and small-group insurance plans. Here’s what each level offers:
- Bronze: Plans cover about 60% of healthcare costs
- Silver: Plans cover about 70% of healthcare costs
- Gold: Plans cover about 80% of healthcare costs
- Platinum: Plans cover about 90% of healthcare costs (these are rare)
- Catastrophic: Plans for people under 30 or those who qualify for special exceptions
All new small-group and individual health insurance plans must fall within one of these levels.
What’s the Difference Between the Plans?
Despite the names of each level, the metal color does not indicate the quality of care the healthcare plan provides. Gold does not have better healthcare services than Silver. Instead, the plan levels are based on the percentage of costs each healthcare provider will pay on behalf of the person enrolled.
Plan Breakdown
- Bronze: While this plan has the most affordable premiums (monthly fees), it has the highest out-of-pocket health care costs. It’s ideal for those who only visit the doctor for annual checkups but want a low-cost plan that protects them against high-cost medical emergencies.
- Silver: With monthly costs higher than Bronze but lower than Gold and Platinum, Sliver is great for those who qualify for “extra savings” and are willing to pay slightly more for their monthly premium to receive more coverage for routine care.
- Gold: Although this level has higher monthly costs than the prior two, it has lower out-of-pocket costs and deductibles. This makes for a great option for those who use healthcare services more frequently.
- Platinum: Those enrolled in this plan will pay the most each month. In return, they receive the lowest out-of-pocket costs and deductibles. This plan is highly beneficial for those who receive medical care most frequently.
- Catastrophic: These health plans have low monthly premiums and very high costs if you need care, making them an affordable means of protection from medical crises (e.g., serious sickness or injury).
Depending on the benefits plan, those with considerable claims may pay a small fraction of the total costs, while another with a few doctor’s visits in the year might pay all or most of the costs.
In short, those considering a Bronze plan will pay less each month but more for incident costs – medical emergencies, etc.- while those considering a Platinum plan will pay more each month but less for any medical events they experience.
The Affordable Care Act offers these health insurance plans through the Health Insurance Marketplace [link to the Antidote blog on the marketplace or Marketplace site], covering a variety of needs. Finding a plan that fits each individual’s requirements and budget has never been easier.
